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GULF COAST ADDICTION MEDICINE NPI 1407301757


NPI Information

NPI: 1407301757
Provider Name: GULF COAST ADDICTION MEDICINE
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 10D2002237

Address:
277 FOREST PARK CIR
PANAMA CITY, FL
ZIP 32405
Phone: (850) 522-1516
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GULF COAST ADDICTION MEDICINE is a community behavioral health in Panama City, FL. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. GULF COAST ADDICTION MEDICINE NPI is 1407301757. The provider is registered as an organization entity type.

The provider's business location address is:

277 FOREST PARK CIR
PANAMA CITY, FL
ZIP 32405-920
Phone: (850) 522-1516
Fax: (850) 522-1518

The provider's authorized official is Jennifer Burkett .
The authorized official title is Office Manager and has the following contact phone number (850) 522-1516.

The CLIA number assigned to this NPI record is 10D2002237 - comprehensive outpatient rehab with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/16/2016 and was last updated on 8/16/2016.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251S00000XCommunity/Behavioral Health03=========01FLORIDAYes

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: 11/14/2023

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