Second Chance Of Northwest Florida

LBN: Second Chance Of Northwest Florida
Second Chance Of Northwest Florida is an health care organization with primary practice located at 819 E 11Th St , Panama City FL 32401-3459. The organization recently has only one registered license in Agencies / Day Training, Developmentally Disabled Services, which is considered as the primary health care specialty. Second Chance Of Northwest Florida can be contacted via phone (850) 769-7779, or through Cupp, Jon via phone (850) 769-7779.

Contact Information

Primary practice address
819 E 11Th St Panama City FL 32401-3459
Phone: (850) 769-7779
Fax: (850) 215-7718
Website:
Map and Directions
Authorized official contact:
Name: Cupp, Jon
Phone: (850) 769-7779

Health care specialties

SpecialtyCodeLicense #State
Agencies / Day Training, Developmentally Disabled Services 251C00000X

Profile Details

NPI number 1114309333
LBN Legal business name Second Chance Of Northwest Florida
DBA Doing business as
Authorized official Cupp, Jon
Entity Organization
Organization subpart 1 No
Enumeration date Jun 24th, 2015
Last updated Jun 24th, 2015 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114309333 NPPES
Florida MEDICAID PENDING

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