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BAYSIDE RECOERY AND WELLNESS CENTER LLC
NPI 1134775976
Community/Behavioral Health in Palm Bay, FL

Active since August 16, 2019CLIA 10D2223959 · Waiver
1501 ROBERT J CONLAN BLVD NE STE 7, PALM BAY, FL 32905(321) 372-6897(321) 372-6896 Get Directions Write a Review

NPPES record last updated: December 13, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 13, 2021, Aug 16, 2019 (2 updates tracked since 2019).

About Bayside Recoery And Wellness Center Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BAYSIDE RECOERY AND WELLNESS CENTER LLC (NPI 1134775976) is a healthcare organization registered as a community/behavioral health in Palm Bay, Florida and active in the NPI registry since August 2019. The organization holds a CLIA Waiver certificate valid through May 10, 2027 and lists Morgan O'shaughnessy, Ceo/clincial Director, as its authorized official.

NPPES Registry Identity

NPI1134775976
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameBAYSIDE RECOVERY AND WELLNESS CENTER LLC
Location Address1501 ROBERT J CONLAN BLVD NE STE 7Palm Bay, FL 32905-3559
Mailing Address1501 Robert J Conlan Blvd Ne Ste 7Palm Bay, FL 32905-3559 · (321) 372-6897 · Fax (321) 372-6896
Phone(321) 372-6897
Fax(321) 372-6896
Organization SubpartNo
Authorized OfficialMorgan O'shaughnessyCeo/clincial Director · (321) 372-6897
Enumeration DateAugust 16, 2019
Last NPPES UpdateDecember 13, 20212 updates tracked since enumeration
NPPES CertifiedDecember 13, 2021
✔ NPI 1134775976 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
Also ListedClinic/Center · Mental Health (Including Community Mental Health Center)Taxonomy 261QM0801X
Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X
Also ListedClinic/Center · RehabilitationTaxonomy 261QR0400X
Also ListedSubstance Abuse Rehabilitation FacilityTaxonomy 324500000X
1501 ROBERT J CONLAN BLVD NE STE 7, Palm Bay, FL 32905
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Other Names 1

Doing Business AsBayside Recoery And Wellness Center Llc

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2223959

Bayside Recovery And Wellness Center LLC · Palm Bay, FL
Active · expires May 10, 2027
CLIA Number10D2223959
Laboratory TypeComp. Outpatient Rehab Facility
Certificate Effective DateMay 11, 2025
Certificate Expiration DateMay 10, 2027
Laboratory DirectorDr. Fritz Jean-Noel
Laboratory Phone(321) 372-6897
Laboratory LocationBayside Recovery And Wellness Center LLC1501 Robert J Conlan Blvd Ste 7, Palm Bay, FL 32905
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AOLANI MAYO LMHC
Counselor (Mental Health)
1501 ROBERT J CONLAN BLVD NE STE 7
PALM BAY, FL 32905
Brevard County (321) 372-6897
CHRISTAL M DICKUN MD
Preventive Medicine (Addiction Medicine)
1501 ROBERT J CONLAN BLVD NE STE 7
PALM BAY, FL 32905
Brevard County (321) 479-4083
FOUNDATIONS HEALTH CENTERS
Preventive Medicine (Addiction Medicine)
1501 ROBERT J CONLAN BLVD NE STE 7
PALM BAY, FL 32905
Brevard County (321) 479-4083

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bayside Recovery And Wellness Center LLC's NPI number?

The NPI number for Bayside Recovery And Wellness Center LLC is 1134775976. It was assigned to this organization in the NPPES registry on August 16, 2019. The provider is doing business as Bayside Recoery And Wellness Center LLC.

Where is Bayside Recovery And Wellness Center LLC located?

Bayside Recovery And Wellness Center LLC is located at 1501 Robert J Conlan Blvd NE Ste 7, Palm Bay, FL 32905. The listed phone number is (321) 372-6897.

What is Bayside Recovery And Wellness Center LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Does Bayside Recovery And Wellness Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2223959) is associated with this NPI, valid through May 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bayside Recovery And Wellness Center LLC was last updated on December 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.