| Tides Edge Recovery Services, Llc | |
|
1597 The Greens Way Jacksonville Beach FL 32250-1401 | |
| (904) 685-9083 | |
| Not Available |
| Full Name | Tides Edge Recovery Services, Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1597 The Greens Way, Jacksonville Beach, Florida |
| Authorized Official Name and Position | Patricia Yost (CEO) |
| Authorized Official Contact | 9042365999 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tides Edge Recovery Services, Llc 390 16th Ave S Jacksonville Beach FL 32250-4961 Ph: (904) 685-9083 | Tides Edge Recovery Services, Llc 1597 The Greens Way Jacksonville Beach FL 32250-1401 Ph: (904) 685-9083 |
| NPI Number | 1992228845 |
|---|---|
| Provider Enumeration Date | 07/24/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992228845 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 1601 (Florida) | Primary |
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