Organization
TIDES EDGE RECOVERY SERVICES, LLC
Active
Organization
TIDES EDGE RECOVERY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA YOST (CEO)
(904) 236-5999
Entity
Organization
Contact information
Practice address
1597 THE GREENS WAY, JACKSONVILLE BEACH, FL 32250-1401
(904) 685-9083
Mailing address
390 16TH AVE S, JACKSONVILLE BEACH, FL 32250-4961
(904) 685-9083
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
1601
FL
Other
Enumeration date
07/24/2017
Last updated
07/21/2022
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