Organization

Life Management Of Nw Fl, Inc.

May also be knows as Life Management Center Of Northwest Florida Inc

Psychiatry Physician in Marianna, FL(View on Map)

Legal Business Name

Life Management Of Nw Fl, Inc.

Also Known As

Life Management Center Of Northwest Florida Inc

NPI Number

1255367579

NPI Type

Organization

Enumeration Date

06/26/2006

Specialties

(Taxonomies)

Code

2084P0800X
251S00000X

Primary Taxonomy

Yes
No

Contact
Information

Purpose

Mailing
Location

Address

525 E 15TH ST
4094 LAFAYETTE ST

City

Panama City
Marianna

State

FL
FL

Postal Code

32405-5412
32446-5648

Country

US
US

Telephone Number

(850) 522-4480
(850) 522-4480

Authorized Official

Name

Edwin Ailes

Title or Position

EXECUTIVE DIRECTOR

Telephone Number

(850) 522-4480

Identifiers

Identifier

060296570

Identifier State

FL

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 03/29/2024

Provider Address

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