Organization
APPETITE FOR LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CELESTE SOUTHARD (EXECUTIVE DIRECTOR)
(850) 470-9111
Entity
Organization
Contact information
Practice address
402 W CERVANTES ST, PENSACOLA, FL 32501-3032
(850) 470-9111
(850) 470-0201
Mailing address
402 W CERVANTES ST, PENSACOLA, FL 32501-3032
(850) 470-9111
(850) 470-0201
Taxonomy
Speciality
Code
Description
License number
State
332U00000X
Home Delivered Meals
Primary
17481460283
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
677803800
—
FL
05
—
677803801
—
FL
Enumeration date
02/12/2014
Last updated
02/12/2014
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