Waters Edge Recovery, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

WATERS EDGE RECOVERY, LLC

Practice address

117 SE Seminole St
Stuart, FL 34994-2122

Phone

(772) 233-5155

Fax

(772) 266-8383

NPI assigned

Aug 21, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tyler Gorman

Title

President/Ceo

Phone

(772) 233-5155

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1377043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394150400000",
    "number": "1114351509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 SE SEMINOLE ST",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942122",
            "telephone_number": "772-233-5155",
            "fax_number": "772-266-8383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 SE SEMINOLE ST",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942122",
            "telephone_number": "772-233-5155",
            "fax_number": "772-266-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERS EDGE RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-21",
        "last_updated": "2014-03-07",
        "status": "A",
        "authorized_official_last_name": "GORMAN",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "772-233-5155"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Wassuta, LMT
• Steven Matthew Wasylik Jr.
• Agnieszka Waszczuk Marshall, PSY D
• Stephanie Maelynn Waterman
• Waters Edge Dermatology Global LLC
• Waters Edge Surgery Center Inc
• Emily Elizabeth Watson
• Holly Watson
• Lindsay A. Watson
• Michele Watson

• Substance Abuse Rehabilitation Facility in Stuart, FL
• Providers in Stuart, FL by specialty
• Substance Abuse Rehabilitation Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.