NPIMap

Organization Active NPI

Sophros Recovery LLC

  • Substance Abuse Rehabilitation Facility
  • Jacksonville, FL
National Provider Identifier
1750962445
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
SOPHROS RECOVERY LLC
Practice address
2511 Saint Johns Bluff Rd S Ste 105&106
Jacksonville, FL 32246-2346
Phone
(808) 388-3916
NPI assigned
Apr 15, 2021
Last updated
Apr 20, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Authorized official

Name
Nicholas Padlo
Title
Ceo
Phone
(808) 388-3916

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU
Substance Abuse Rehabilitation Facility 324500000X NU Primary

Addresses

Primary practice location

2511 Saint Johns Bluff Rd S Ste 105&106
Jacksonville, FL 32246-2346

Mailing address

2511 Saint Johns Bluff Rd S Ste 105&106
Jacksonville, FL 32246-2346
Phone (808) 388-3916

National Provider Directory

National Provider Directory

Locations

2511 Saint Johns Bluff Rd S
Ste 105106
Jacksonville, FL 32246
Phone (808) 388-3916

2511 Saint Johns Bluff Rd S
Ste 106
Jacksonville, FL 32246
Phone (410) 456-4294

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618876800000",
    "number": "1750962445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 SAINT JOHNS BLUFF RD S STE 105&106",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322462346",
            "telephone_number": "808-388-3916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 SAINT JOHNS BLUFF RD S STE 105&106",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322462346",
            "telephone_number": "808-388-3916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOPHROS RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-15",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A",
        "authorized_official_last_name": "PADLO",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "808-388-3916"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; 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.