Organization
TIDES EDGE RECOVERY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA YOST (VICE PRESIDENT)
(904) 778-6161
Entity
Organization
Contact information
Practice address
144 11TH AVE N, JACKSONVILLE BEACH, FL 32250-7224
(904) 685-9083
Mailing address
75 12TH ST S, JACKSONVILLE BEACH, FL 32250-3422
(904) 685-9083
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
08/30/2024
Last updated
08/30/2024
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