Healthcare Provider Details
I. General information
NPI: 1427947662
Provider Name (Legal Business Name): PRESTIGE BEHAVIORAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/01/2025
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4947 TAMIAMI TRL N STE 201
NAPLES FL
34103-3014
US
IV. Provider business mailing address
2105 SW 20TH AVE
CAPE CORAL FL
33991-3514
US
V. Phone/Fax
- Phone: 239-331-3783
- Fax: 321-413-3808
- Phone: 239-789-0041
- Fax: 321-413-3808
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
ARIANNA
DANTA
Title or Position: CEO
Credential:
Phone: 239-789-0041