Skip Navigation

Provider Information for 1891318077

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

THE SHORE DETOX LLC

Other Name:   Doing Business As: BOCA RECOVERY CENTER
Organization Subpart: NO

Organization NPI: 1891318077

Calendar   Last Updated:  2021-04-14
  Certification Date:  2021-04-14

Details

Name Value
NPI 1891318077
Enumeration Date 2020-05-22
NPI Type 2- Organization
Status Active
Authorized Official Information Name: CHRISTOPHER FERRY
Title: PRESIDENT
Phone: 609-202-5669
Mailing Address 21301 POWERLINE RD STE 311
BOCA RATON, FL 33433-2305
United States

Phone: 561-763-4773 | Fax: 561-516-6215
View Map External Link
Primary Practice Address 30 W JIMMIE LEEDS RD
GALLOWAY, NJ 08205-9421
United States

Phone: 609-270-3068 | Fax: 561-516-6215
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Direct Messaging Address contact@bocarecoverycenter.com Direct CSV 30 W JIMMIE LEEDS RD
GALLOWAY, NJ 08205-9421
United States
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 324500000X - Substance Abuse Rehabilitation Facility