Organization · Type 2 NPI

Tidal Wave Recovery Center LLC

Substance Use Disorder Rehabilitation Clinic/Center · Philadelphia, PA

NPI number 1114867934 Active

Practice location

3396 Miller St
Philadelphia, PA 19134-5325

Call (215) 901-3512 Map

Specialties and licenses

TaxonomyCodeLicense
Clinic/Center 261Q00000XNone listed
Adult Mental Health Clinic/Center 261QM0850XNone listed
Substance Use Disorder Rehabilitation Clinic/Center Primary 261QR0405XNone listed
Substance Abuse Rehabilitation Facility 324500000XNone listed

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About NPI 1114867934

Tidal Wave Recovery Center LLC's National Provider Identifier is 1114867934, issued on Mar 31, 2026. The primary taxonomy on file is Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X), and the practice location is in Philadelphia, PA. The record was last updated on Mar 31, 2026.