LIFE MANAGEMENT CENTER OF NORTHWEST FLORIDA INC NPI 1003022369

Community/Behavioral Health in Panama City, FL

NPI 1003022369 Organization Community/Behavioral Health

About LIFE MANAGEMENT CENTER OF NORTHWEST FLORIDA INC

Life Management Center Of Northwest Florida Inc is a provider established in Panama City, Florida specializing in community/behavioral health. The NPI number of Life Management Center Of Northwest Florida Inc is 1003022369 and was assigned on May 2007. The practitioner's primary taxonomy code is 251S00000X. The provider is registered as an organization and their NPI record was last updated 13 years ago. The authorized official of this NPI record is Mr. Edwin R. Ailes Lmft (Executive Director)

NPI

1003022369

Provider NameLIFE MANAGEMENT CENTER OF NORTHWEST FLORIDA INC
Provider Location Address525 E 15TH ST PANAMA CITY, FL 32405
Provider Mailing Address525 E 15TH ST PANAMA CITY, FL 32405
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date05-15-2007
Last Update Date07-31-2008


Primary Taxonomy

Taxonomy Code251S00000X
ClassificationCommunity/Behavioral Health
TypeAgencies
Taxonomy DescriptionA private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

Business Address

LIFE MANAGEMENT CENTER OF NORTHWEST FLORIDA INC
525 E 15TH ST
PANAMA CITY, FL
ZIP 32405
Phone: (850) 522-4480
Fax: (850) 914-6281

Get Directions


Mailing Address

LIFE MANAGEMENT CENTER OF NORTHWEST FLORIDA INC
525 E 15TH ST
PANAMA CITY, FL
ZIP 32405
Phone: (850) 522-4480
Fax: (850) 914-6281



Authorized Official

Authorized Official NameMR. EDWIN R. AILES LMFT
Authorized Official TitleEXECUTIVE DIRECTOR
Authorized Official Phone(850) 522-8840

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
141301500MEDICAID (05)FL

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1710983739 BRIAN W JOSEPH MD
Individual
Psychiatry & Neurology (Psychiatry)525 E 15TH ST
PANAMA CITY, FL 32405
(850) 522-4485
1639168958MR. EDWIN R AILES LMFT
Individual
Marriage & Family Therapist525 E 15TH ST
PANAMA CITY, FL 32405
(850) 522-4485
1700876711 KENNETH CHISHOLM LMHC
Individual
Counselor (Mental Health)525 E 15TH ST
PANAMA CITY, FL 32405
(850) 522-4485
1336139344 LORRETTA GLASS LMFT
Individual
Marriage & Family Therapist525 E 15TH ST
PANAMA CITY, FL 32405
(850) 522-4485
1326038332 PETER HAMPTON PHD
Individual
Psychologist525 E 15TH ST
PANAMA CITY, FL 32405
(850) 522-4485
1043200058 JULIE KITZEROW LMFT
Individual
Marriage & Family Therapist525 E 15TH ST
PANAMA CITY, FL 32405
(850) 522-4485
1992795264 JACK HOWELL LMHC
Individual
Counselor (Mental Health)525 E 15TH ST
PANAMA CITY, FL 32405
(850) 522-4485
1619967981 SHARON MAYHEW LMHC
Individual
Counselor (Mental Health)525 E 15TH ST
PANAMA CITY, FL 32405
(850) 522-4485
1467442780 JUDY BROCK LMHC
Individual
Counselor (Mental Health)525 E 15TH ST
PANAMA CITY, FL 32405
(850) 522-4485
1104816412 DONNA SHAFFER LMHC
Individual
Counselor (Mental Health)525 E 15TH ST
PANAMA CITY, FL 32405
(850) 522-4485
1720078025 JULIA PATTERSON LMHC
Individual
Counselor (Mental Health)525 E 15TH ST
PANAMA CITY, FL 32405
(850) 522-4485
1073503389 DIANE PIPKIN LCSW
Individual
Social Worker (Clinical)525 E 15TH ST
PANAMA CITY, FL 32405
(850) 522-4485
1083605109 JOHN RAY LMHC
Individual
Counselor (Mental Health)525 E 15TH ST
PANAMA CITY, FL 32405
(850) 522-4485
1598746885 VINCY PORTER LMHC
Individual
Counselor (Mental Health)525 E 15TH ST
PANAMA CITY, FL 32405
(850) 522-4485
1780667022 FORREST ED DENNIS LMHC
Individual
Counselor (Mental Health)525 E 15TH ST
PANAMA CITY, FL 32405
(850) 522-4485
1952384737 WANDA RANGER LMHC
Individual
Counselor (Mental Health)525 E 15TH ST
PANAMA CITY, FL 32405
(850) 522-4485
1689650954 TANYA LEWIS LMHC
Individual
Counselor (Mental Health)525 E 15TH ST
PANAMA CITY, FL 32405
(850) 522-4485
1588690895 EILEEN BOOTH LMHC
Individual
Counselor (Mental Health)525 E 15TH ST
PANAMA CITY, FL 32405
(850) 522-4480
1235169517 DIANNA COMBS MA
Individual
Counselor (Mental Health)525 E 15TH ST
PANAMA CITY, FL 32405
(850) 522-4480
1386674570 JANE RIGBY RN
Individual
Registered Nurse525 E 15TH ST
PANAMA CITY, FL 32405
(850) 522-4480

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.