EMERALD COAST WELLNESS CENTER LLC NPI 1417287855

NPI Information

NPI: 1417287855
Provider Name: EMERALD COAST WELLNESS CENTER, LLC
Classification: Clinic/Center - 261QM0850X
Specialization: Adult Mental Health
Entity Type: Organization
Address: 138 BAYWIND DR
NICEVILLE, FL
ZIP 32578
Phone: (850) 398-4155

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NPI Details

EMERALD COAST WELLNESS CENTER, LLC is an adult mental health clinic center in Niceville, FL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. EMERALD COAST WELLNESS CENTER, LLC NPI is 1417287855. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

138 BAYWIND DR
NICEVILLE, FL
ZIP 32578-800
Phone: (850) 398-4155
Fax: (850) 398-4142

The provider's authorized official is Henry Alexander Boilini .
The authorized official title is Psychiatrist and has the following contact phone number (850) 543-5678.

The enumeration date for this NPI number is 1/7/2010 and was last updated on 9/2/2015.

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	Primary
1	2084P0805X	Psychiatry & Neurology	Geriatric Psychiatry	No
2	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	No
3	261QM0850X	Clinic/Center	Adult Mental Health	Yes

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
1	008056800	MEDICAID	FLORIDA
2	DY718A	MEDICARE PIN

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: 11/21/2025

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