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General NPI Number Information
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NPI Number | 1255730511
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Entity Type | Organization
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Legal Business Name | SHANDS RECOVERY, LLC
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Dates
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Enumeration Date | 08/22/2014
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 4305 NW 90TH BLVD
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City | GAINESVILLE
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State | FL
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Zip | 32606-5686
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Country | US
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Telephone | 352-265-5500
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Fax | 352-265-5504
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Provider Business Mailing Address
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Address Line | 4305 NW 90TH BLVD
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City | GAINESVILLE
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State | FL
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Zip | 32606-5686
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Country | US
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Telephone | 352-265-5500
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Fax | 352-265-5504
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Authorized Official
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Title or Position | CEO
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Name | MICHAEL D. HOLMES
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Credential |
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Telephone | 352-733-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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