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General NPI Number Information
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NPI Number | 1396876157
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH ASSOCIATION OF OKALOOSA & WALTON COUNTIES, INC.
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 571 MOONEY RD NE
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-1859
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Country | US
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Telephone | 850-244-1040
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Fax | 850-244-2573
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Provider Business Mailing Address
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Address Line | 571 MOONEY RD NE
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-1859
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Country | US
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Telephone | 850-244-1040
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Fax | 850-244-2573
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. VIRGINIA GLYNN BARR
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Credential | ACSW
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Telephone | 850-244-1040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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