Bridge to Shore Recovery, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

5501 Issued in FL

Legal business name

BRIDGE TO SHORE RECOVERY, LLC

Practice address

3930 US 1 S
St Augustine, FL 32086-7089

Phone

(904) 540-4232

NPI assigned

Feb 12, 2015

Organization subpart

No

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

Authorized official

Name

Phillip D Snyder

Title

Admissions Supervisor

Phone

(904) 217-0480

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• The Augustine Recovery Center Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Bridge to Shore Recovery LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Bridge to Shore Recovery, LLC

  • Substance Abuse Rehabilitation Facility
  • Saint Augustine, FL
  • NPI 1265004576
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lauren Chane, LCSW

  • Clinical Social Worker
  • Saint Augustine, FL
  • NPI 1265075584
  NPD

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

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708473600000",
    "number": "1174914048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 US 1 S",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320867089",
            "telephone_number": "904-540-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 US 1 S",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320867089",
            "telephone_number": "904-540-4232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Davis St",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320840476",
            "country_code": "US",
            "telephone_number": "904-217-0480",
            "fax_number": "904-217-3081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRIDGE TO SHORE RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-12",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A",
        "authorized_official_last_name": "SNYDER",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMISSIONS SUPERVISOR",
        "authorized_official_telephone_number": "904-217-0480"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "FL",
            "license": "5501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD",
            "identifier": "ME38055",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN",
            "identifier": "APRN2520572",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "SW16603",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMHC",
            "identifier": "MH17663",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Augustine Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Augustine Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brett Cutler DPM PA
• Brett Huether LLC
• Alayna Miller Brewer, P.T., DPT
• Christina Marie Brewton, OTR/L
• Lisa M Brice, LCSW
• Bridge to Shore Recovery, LLC
• Brightside Pediatrics
• Heather Brinker
• Lisa Britt, LMHC
• Lisa Kay Britton-Willette, RN

• Substance Abuse Rehabilitation Facility in St Augustine, FL
• Providers in St Augustine, 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 Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.