SECOND CHANCE OF NORTHWEST FLORIDA NPI 1114309333

NPI Information

  • NPI: 1114309333
  • Provider Name: SECOND CHANCE OF NORTHWEST FLORIDA
  • Classification: Day Training, Developmentally Disabled Services - 251C00000X
  • Entity Type: Organization
  • Address: 819 E 11TH ST
    PANAMA CITY, FL
    ZIP 32401
  • Phone: (850) 769-7779

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NPI Details

SECOND CHANCE OF NORTHWEST FLORIDA is a day training developmentally disabled services in Panama City, FL. The provider is these agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. SECOND CHANCE OF NORTHWEST FLORIDA NPI is 1114309333. The provider is registered as an organization entity type.

The provider's business location address is:

819 E 11TH ST
PANAMA CITY, FL
ZIP 32401-459
Phone: (850) 769-7779
Fax: (850) 215-7718

The provider's authorized official is Jon Cupp .
The authorized official title is Director and has the following contact phone number (850) 769-7779.

The enumeration date for this NPI number is 6/24/2015 and was last updated on 6/24/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251C00000XDay Training, Developmentally Disabled ServicesYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1PENDINGMEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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