Healthcare Provider Details

I. General information

NPI: 1073439782
Provider Name (Legal Business Name): WOODSIDE RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3717 CHAMBLEE DUNWOODY RD
CHAMBLEE GA
30341-2062
US

IV. Provider business mailing address

1101 54TH ST
WEST PALM BEACH FL
33407-2419
US

V. Phone/Fax

Practice location:
  • Phone: 561-901-4923
  • Fax:
Mailing address:
  • Phone: 561-901-4923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANNEMARIE SINCAVAGE
Title or Position: DIRECTOR
Credential:
Phone: 561-901-4923