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General NPI Number Information
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NPI Number | 1922977693
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Entity Type | Organization
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Legal Business Name | NAPLES INTEGRATED RECOVERY
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Dates
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Enumeration Date | 11/01/2025
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Last Update Date | 11/01/2025
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Provider Practice Location Address
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Address Line | 1715 HERITAGE TRL STE 203
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City | NAPLES
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State | FL
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Zip | 34112-8715
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Country | US
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Telephone | 239-212-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 171 29TH ST SW
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City | NAPLES
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State | FL
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Zip | 34117-3120
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Country | US
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Telephone | 239-777-0736
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRIAN GRANNEMAN
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Credential | LMHC, CAP, CCTP
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Telephone | 239-777-0736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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