Healthcare Provider Details

I. General information

NPI: 1891176475
Provider Name (Legal Business Name): RECOVERY BY THE SEA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2015
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 SE MARTIN SQUARE CORPORATE PKWY
STUART FL
34994
US

IV. Provider business mailing address

PO BOX 1899
WEST PALM BEACH FL
33402-1899
US

V. Phone/Fax

Practice location:
  • Phone: 772-888-3025
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number4301
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number4301
License Number StateFL

VIII. Authorized Official

Name: DAVID FARACHE
Title or Position: OWNER
Credential:
Phone: 772-888-3025