Organization
LIFE MANAGEMENT CENTER OF NORTHWEST FLORIDA INC.
Active
Other names
Life Management Center
Organization subpart
No
Provider details
NPI number
Authorized official
EDWIN AILES (EXECUTIVE DIRECTOR)
(850) 522-4485
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
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060296528
—
FL
Enumeration date
07/12/2006
Last updated
03/29/2024
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