Organization
PANAMA CITY DEVELOPMENTAL CENTER
Active
Other names
Pensacola Care Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLLIS PENNYWELL (ADMINISTRATOR)
(850) 769-7771
Entity
Organization
Contact information
Practice address
1407 LINCOLN DR, PANAMA CITY, FL 32401-2870
(850) 769-7771
(850) 522-8966
Mailing address
1407 LINCOLN DR, PANAMA CITY, FL 32401-2870
(850) 769-7771
(850) 522-8966
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
4053095
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8526900
—
FL
Enumeration date
07/20/2005
Last updated
08/22/2020
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