Bridge to Shore Recovery, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

BRIDGE TO SHORE RECOVERY, LLC

Practice address

3 Davis St
Saint Augustine, FL 32084-0476

Phone

(042) 170-4809

Fax

(904) 217-3081

NPI assigned

Jul 15, 2021

Organization subpart

Yes

Parent organization

THE AUGUSTINE RECOVERY CENTERAs reported in NPPES

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

Tax ID family

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

Part of

Bridge to Shore Recovery LLC

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
  • St Augustine, FL
  • NPI 1174914048
  NPD tax ID

Locations

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": "1626307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708560000000",
    "number": "1265004576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 US 1 S",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320867089",
            "telephone_number": "904-217-0480",
            "fax_number": "904-217-3081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 DAVIS ST",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320840476",
            "telephone_number": "042-170-4809",
            "fax_number": "904-217-3081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE TO SHORE RECOVERY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE AUGUSTINE RECOVERY CENTER",
        "enumeration_date": "2021-07-15",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "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": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD",
            "identifier": "ME38055",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMHC",
            "identifier": "MH17663",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "SW16603",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN",
            "identifier": "APRN2520572",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Augustine Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 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
• Betsy Britton, MA,CCC

• Substance Abuse Rehabilitation Facility in Saint Augustine, FL
• Providers in Saint 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 22, 2024; 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.