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General NPI Number Information
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NPI Number | 1770780710
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Entity Type | Organization
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Legal Business Name | OKALOOSA COUNTY BOARD OF COUNTY COMMISSIONERS
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1250 EGLIN PKWY STE G117
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City | SHALIMAR
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State | FL
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Zip | 32579-1234
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Country | US
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Telephone | 850-651-7497
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Fax | 850-651-7725
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Provider Business Mailing Address
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Address Line | 1804 LEWIS TURNER BLVD
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-5205
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Country | US
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Telephone | 850-651-7105
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN
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Name | MR. DON AMUNDS
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Credential |
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Telephone | 850-651-7105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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