Willowbend Retreats, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

12-58-AD-6213-01 Issued in FL

Legal business name

WILLOWBEND RETREATS, LLC

Practice address

2033 Wood St
Suite 215
Sarasota, FL 34237-7900

Phone

(941) 328-8953

Fax

(941) 866-0427

NPI assigned

Aug 13, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Michael Dylan Gregory

Title

Ceo

Phone

(941) 328-8953

Specialties & licenses 1

Addresses

Other names 1

• Willowbend Recovery Doing business as

Locations

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

{
    "created_epoch": "1281657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281657600000",
    "number": "1710292883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2033 WOOD ST",
            "address_2": "SUITE 215",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342377900",
            "telephone_number": "941-328-8953",
            "fax_number": "941-866-0427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2033 WOOD ST",
            "address_2": "SUITE 215",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342377900",
            "telephone_number": "941-328-8953",
            "fax_number": "941-866-0427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOWBEND RETREATS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-13",
        "last_updated": "2010-08-13",
        "status": "A",
        "authorized_official_last_name": "GREGORY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DYLAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "941-328-8953",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "FL",
            "license": "12-58-AD-6213-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willowbend Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie Nicole Williams, MD
• Thomas H Williams, MD
• Trevor J Williams, APRN
• Tysherika P Williams
• Willow River Wellness, LLC
• Pamela Wilsen, LMHC
• Patricia Lynn Wilson-Lavigne, M.S. CCC-SLP
• Brian Wilson, D.C.
• Courtney Elizabeth Wilson, RNBSN
• Heather Lee Wilson, DPM

• Substance Abuse Rehabilitation Facility in Sarasota, FL
• Providers in Sarasota, 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 Aug 13, 2010; 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.