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SHORELINE MEDICAL ADDICTION TREATMENT LLC NPI 1659051647


NPI Information

NPI: 1659051647
Provider Name: SHORELINE MEDICAL ADDICTION TREATMENT LLC
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 10D2286417

Address:
602 W INDIAN RIVER BLVD STE 2
EDGEWATER, FL
ZIP 32132
Phone: (386) 868-2619
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SHORELINE MEDICAL ADDICTION TREATMENT LLC is a rehabilitation and substance use disorder clinic center in Edgewater, FL. SHORELINE MEDICAL ADDICTION TREATMENT LLC NPI is 1659051647. The provider is registered as an organization entity type.

The provider's business location address is:

602 W INDIAN RIVER BLVD STE 2
EDGEWATER, FL
ZIP 32132-500
Phone: (386) 868-2619

The provider's authorized official is Stephen Charles Viel .
The authorized official title is Managing Partner and has the following contact phone number (850) 339-6808.

The CLIA number assigned to this NPI record is 10D2286417 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/24/2023 and was last updated on 7/24/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR0405XClinic/CenterRehabilitation, Substance Use DisorderYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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