Healthcare Provider Details

I. General information

NPI: 1457336604
Provider Name (Legal Business Name): WEST FLORIDA BEHAVIORAL HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2005
Last Update Date: 03/01/2024
Certification Date: 03/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8333 N DAVIS HWY 11TH FLOOR
PENSACOLA FL
32514-6050
US

IV. Provider business mailing address

2000 HEALTH PARK DR
BRENTWOOD TN
37027-4692
US

V. Phone/Fax

Practice location:
  • Phone: 850-474-8360
  • Fax: 850-969-2970
Mailing address:
  • Phone: 615-373-7406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD DILALLA
Title or Position: VICE PRESIDENT
Credential:
Phone: 603-531-2657