Provider Demographics
NPI:1013954353
Name:CC-NAPLES, INC.
Entity Type:Organization
Organization Name:CC-NAPLES, INC.
Other - Org Name:BENTLEY CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP & GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:COPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-803-8555
Mailing Address - Street 1:875 RETREAT DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-7927
Mailing Address - Country:US
Mailing Address - Phone:239-431-2100
Mailing Address - Fax:239-431-2199
Practice Address - Street 1:875 RETREAT DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-7927
Practice Address - Country:US
Practice Address - Phone:239-431-2100
Practice Address - Fax:239-431-2199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF1050095314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106062Medicare Oscar/Certification