Organization
LIFE MANAGEMENT CENTER OF NORTHWEST FLORIDA INC
Active
Parent organization
LIFE MANAGEMENT CENTER OF NORTHWEST FLORIDA INC.
Other names
Life Management Center of Northwest Florida Inc
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFE MANAGEMENT CENTER OF NORTHWEST FLORIDA INC.
Authorized official
EDWIN AILES (EXECUTIVE DIRECTOR)
(850) 522-4480
Entity
Organization
Contact information
Practice address
16869 NE PEAR ST, BLOUNTSTOWN, FL 32424-1774
(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
2084P0800X
Psychiatry Physician
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060296538
—
FL
Enumeration date
07/04/2006
Last updated
04/24/2025
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