NPIMap

Organization Active NPI

Nu-Way Life Recovery Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fort Pierce, FL
National Provider Identifier
1497135495
Registry record updated Jul 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
NU-WAY LIFE RECOVERY CENTER
Practice address
1905 S 25TH St Ste 103
Fort Pierce, FL 34947-4739
Phone
(772) 577-7200
NPI assigned
Jun 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2016

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

Authorized official

Name
Dennis Nystrom
Title
Ceo
Phone
(317) 319-3132

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

1905 S 25TH St Ste 103
Fort Pierce, FL 34947-4739

Mailing address

1905 S 25TH St Ste 103
Fort Pierce, FL 34947-4739

National Provider Directory

National Provider Directory
Tax ID family
Dynamic Life Recovery Centers2 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.

Locations

1905 S 25th St
Ste 103
Fort Pierce, FL 34947
Phone (772) 577-7200

NPI Registry JSON

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469577600000",
    "number": "1497135495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 S 25TH ST STE 103",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349474739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 S 25TH ST STE 103",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349474739",
            "telephone_number": "772-577-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NU-WAY LIFE RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-04",
        "last_updated": "2016-07-27",
        "status": "A",
        "authorized_official_last_name": "NYSTROM",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-319-3132"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; 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.