Healthcare Provider Details

I. General information

NPI: 1124415328
Provider Name (Legal Business Name): PSYCHACCESS AND RECOVERY SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2015
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8665 BAYPINE RD STE 215
JACKSONVILLE FL
32256-7541
US

IV. Provider business mailing address

8665 BAYPINE RD STE 215
JACKSONVILLE FL
32256-7541
US

V. Phone/Fax

Practice location:
  • Phone: 844-808-9096
  • Fax: 904-638-8752
Mailing address:
  • Phone: 844-808-9096
  • Fax: 904-638-8752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number299994442
License Number StateFL

VIII. Authorized Official

Name: BLAKE EHLER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 844-808-9096