# BEACHES RECOVERY SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073907937
- **Authorized official:** SAM DARCY MA, CAP (COMPLIANCE DIRECTOR)
- **Authorized official phone:** (575) 779-2456

## Contact information

- **Practice address:** 75 12TH ST S, JACKSONVILLE BEACH, FL 32250-3422
- **Practice address phone:** (904) 685-9083
- **Practice address fax:** (904) 485-8427
- **Mailing address:** 75 12TH ST S, JACKSONVILLE BEACH, FL 32250-3422
- **Mailing address phone:** (904) 685-9083

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | — | NULL | — |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | — | — | — |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | — | NULL | — |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/27/2015
- **Last updated:** 05/16/2024