BEACHES RECOVERY SERVICES LLC NPI 1073907937

NPI Information

  • NPI: 1073907937
  • Provider Name: BEACHES RECOVERY SERVICES LLC
  • Classification: Clinic/Center - 261QM1300X
  • Specialization: Multi-Specialty
  • Entity Type: Organization
  • CLIA Number: 10D2178741
  • Address: 75 12TH ST S
    JACKSONVILLE BEACH, FL
    ZIP 32250
  • Phone: (904) 685-9083

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NPI Details

BEACHES RECOVERY SERVICES LLC is a multi-specialty clinic center in Jacksonville Beach, FL. BEACHES RECOVERY SERVICES LLC NPI is 1073907937. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

75 12TH ST S
JACKSONVILLE BEACH, FL
ZIP 32250-422
Phone: (904) 685-9083
Fax: (904) 485-8427

The provider's authorized official is Sam Darcy .
The authorized official title is Compliance Director and has the following contact phone number (575) 779-2456.

The CLIA number assigned to this NPI record is 10D2178741 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/27/2015 and was last updated on 5/16/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TA0400XPsychologistAddiction (Substance Use Disorder)No
22084A0401XPsychiatry & NeurologyAddiction MedicineNo
3261QM1300XClinic/CenterMulti-SpecialtyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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