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Organization
LIFE MANAGEMENT OF NW FL, INC.
Active
Organization
LIFE MANAGEMENT OF NW FL, INC.
Active
Other names
Life Management Center
Organization subpart
No
Provider details
NPI number
Authorized official
EDWIN AILES (EXECUTIVE DIRECTOR)
(850) 522-4480
Entity
Organization
Contact information
Practice address
525 E 15TH ST, PANAMA CITY, FL 32405-5412
(850) 522-4480
(850) 914-6281
Mailing address
525 E 15TH ST, PANAMA CITY, FL 32405-5412
(850) 522-4480
(850) 914-6281
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
—
—
251B00000X
Case Management Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060296514
—
FL
Enumeration date
07/12/2006
Last updated
03/29/2024
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