Provider Demographics
NPI:1780863282
Name:LAURIE DAWSON ADULT FAMILY CARE
Entity Type:Organization
Organization Name:LAURIE DAWSON ADULT FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-747-9269
Mailing Address - Street 1:1106 EVERITT AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-5028
Mailing Address - Country:US
Mailing Address - Phone:850-747-9269
Mailing Address - Fax:850-215-9870
Practice Address - Street 1:1106 EVERITT AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-5028
Practice Address - Country:US
Practice Address - Phone:850-747-9269
Practice Address - Fax:850-215-9870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL10655323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility