# RIDE THE WAVE THERAPY SERVICES

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

## Provider details

- **NPI number:** 1467068023
- **Authorized official:** JANA SANFORD-HELLER (OWNER)
- **Authorized official phone:** (352) 256-0658

## Contact information

- **Practice address:** 150 SOUTHPARK BLVD STE 202, SAINT AUGUSTINE, FL 32086-5179
- **Practice address phone:** (904) 217-3103
- **Mailing address:** 247 PORTADA DR, SAINT AUGUSTINE, FL 32095-1637

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/18/2020
- **Last updated:** 09/18/2020