Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tidal Wave Recovery Center LLC

Organization Clinic/Center · NPI 1114867934

Tidal Wave Recovery Center LLC is a Clinic/Center in Philadelphia, Pennsylvania. Registered with an NPI since 2026.

In the registry since
2026
Specialties on file
4
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3396 Miller St
Philadelphia, PA 19134-5325
Phone: (215) 901-3512
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Substance Use Disorder Rehabilitation Clinic/Center (primary) Taxonomy 261QR0405X
Clinic/Center Taxonomy 261Q00000X
Adult Mental Health Clinic/Center Taxonomy 261QM0850X
Substance Abuse Rehabilitation Facility Taxonomy 324500000X

Record details

NPI number1114867934
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Werner — Ceo · (215) 370-3646
NPI enumeratedMarch 31, 2026
Last updated in NPPESMarch 31, 2026
Certification dateMarch 31, 2026
Mailing address3396 Miller St, Philadelphia, PA 19134-5325

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