Provider Demographics
NPI:1265869762
Name:NAPLES REHAB, INC
Entity type:Organization
Organization Name:NAPLES REHAB, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MH COUNSELER
Authorized Official - Phone:239-400-5555
Mailing Address - Street 1:4100 CORPORATE SQ
Mailing Address - Street 2:UNIT 154
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-4714
Mailing Address - Country:US
Mailing Address - Phone:239-400-5555
Mailing Address - Fax:
Practice Address - Street 1:4100 CORPORATE SQ
Practice Address - Street 2:UNIT 154
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-4714
Practice Address - Country:US
Practice Address - Phone:239-400-5555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5946103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty