Whalio Doctors

NPI 1588098495

The Shores Treatment & Recovery Services, LLC

Organisation Substance Abuse Rehabilitation Facility Port Saint Lucie, FL

Practice location

Address
1405 SE Goldtree Dr Suite a, Port Saint Lucie, FL 34952-7563
Phone
(772) 800-3990

Authorised official

Name
Lyle Ryant Fried
Title
President & Ceo
Phone
(772) 800-3990

Registered specialties (4)

Substance Abuse Rehabilitation Facility Primary
Residential Treatment Facilities Taxonomy 324500000X Licence 1956AD703301 (FL)
Addiction (Substance Use Disorder) Counselor
Behavioral Health & Social Service Providers Taxonomy 101YA0400X Licence 1956AD703301 (FL)
Mental Health Counselor
Behavioral Health & Social Service Providers Taxonomy 101YM0800X Licence MH11953 (FL)
Professional Counselor
Behavioral Health & Social Service Providers Taxonomy 101YP2500X Licence 4809 (FL)

Registry record

NPI
1588098495
Entity type
Organization
NPI issued
27 Aug 2013
Record last updated
24 Feb 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.