| NPI | 1588098495 |
|---|---|
| Other Name | THE SHORES |
| Entity Type | Organization |
| Authorized Contact | LYLE RYANT FRIED President & CEO 772-800-3990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL 1956AD703301) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 1956AD703301) |
| 101YM0800X Counselor, Mental Health (Licence: FL MH11953) | |
| 101YP2500X Counselor, Professional (Licence: FL 4809) | |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2016-02-24 |