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Contact Information

OKALOOSA MENTAL HEALTH & PSYCHIATRIC CENTER, INC.
101 S JEFFERSON ST
SUITE C
PENSACOLA, FL32502-5656
 Phone: 850-432-3334
 Fax: 850-432-3353
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Addiction Medicine

2084A0401X 79 Physician/Addiction Medicine
 

Addiction Psychiatry

2084P0802X 86 Physician/Neuropsychiatry
 

Child & Adolescent Psychiatry

2084P0804X 86 Physician/Neuropsychiatry
 

Clinical Pharmacology

208U00000X
 

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
 

Neurodevelopmental Disabilities

2084P0005X 86 Physician/Neuropsychiatry
 

Neurology

2084N0400X 13 Physician/Neurology
 

Neurology with Special Qualifications in Child Neurology

2084N0402X 13 Physician/Neurology
 

Pain Medicine

2084P2900X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for OKALOOSA MENTAL HEALTH & PSYCHIATRIC CENTER, INC.

NPI # 1699970962
LBN Legal business name OKALOOSA MENTAL HEALTH & PSYCHIATRIC CENTER, INC.
Authorized official KIUMARS SHAMS - (EXECUTIVE MEDICAL DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 06/18/2007
Last updated 03/05/2012 - About 14 years ago
Identifiers
FL License # ME29949
FL Medicaid 038295700
FL Other 79178 BC BS FL
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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