TIDES EDGE RECOVERY SERVICES, LLC
NPI 1992228845
Clinic/Center - Multi-Specialty in Jacksonville Beach, FL

Q: What is Tides Edge Recovery Services, LLC's NPI number?

The NPI number for Tides Edge Recovery Services, LLC is 1992228845. It was assigned to this organization in the NPPES registry on July 24, 2017.

Q: What is Tides Edge Recovery Services, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Active since July 24, 2017

1597 THE GREENS WAY, JACKSONVILLE BEACH, FL 32250(904) 685-9083 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Dec 19, 2019, Jul 24, 2017 (3 updates tracked since 2017).

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About Tides Edge Recovery Services, Llc NPPES

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

TIDES EDGE RECOVERY SERVICES, LLC (NPI 1992228845) is a healthcare organization registered as a multi-specialty in Jacksonville Beach, Florida and active in the NPI registry since July 2017. The organization lists Patricia Yost, Ceo, as its authorized official.

NPPES Registry Identity

NPI1992228845

Entity TypeOrganization

Primary Taxonomy261QM1300X

Legal Business NameTIDES EDGE RECOVERY SERVICES, LLC

Location Address1597 THE GREENS WAYJacksonville Beach, FL 32250-1401

Mailing Address390 16th Ave SJacksonville Beach, FL 32250-4961 · (904) 685-9083

Phone(904) 685-9083

Organization SubpartNo

Authorized OfficialPatricia YostCeo · (904) 236-5999

Enumeration DateJuly 24, 2017

Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration

NPPES CertifiedDecember 19, 2019

✔ NPI 1992228845 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities

Taxonomy Code261QM1300X

License✔ Licensed in FL · 1601

1597 THE GREENS WAY, Jacksonville Beach, FL 32250

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Other Providers at the Same Location NPPES 2

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

KATHLEEN DOUGHERTY

Registered Nurse (Addiction (Substance Use Disorder))

1597 THE GREENS WAY
JACKSONVILLE BEACH, FL 32250

Duval County (904) 425-9648

TIDES EDGE RECOVERY SERVICES, LLC

Substance Abuse Rehabilitation Facility

1597 THE GREENS WAY
JACKSONVILLE BEACH, FL 32250

Duval County (904) 685-9083

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 Tides Edge Recovery Services, LLC's NPI number?

The NPI number for Tides Edge Recovery Services, LLC is 1992228845. It was assigned to this organization in the NPPES registry on July 24, 2017.

Where is Tides Edge Recovery Services, LLC located?

Tides Edge Recovery Services, LLC is located at 1597 The Greens Way, Jacksonville Beach, FL 32250. The listed phone number is (904) 685-9083.

What is Tides Edge Recovery Services, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

When was this NPI record last updated?

The NPPES record for Tides Edge Recovery Services, LLC was last updated on July 21, 2022. 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.