Provider Demographics
NPI:1215639547
Name:DARE TO REHAB
Entity type:Organization
Organization Name:DARE TO REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAREON
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRADWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:850-980-4963
Mailing Address - Street 1:306 ROBINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32305-7244
Mailing Address - Country:US
Mailing Address - Phone:850-980-4963
Mailing Address - Fax:
Practice Address - Street 1:306 ROBINWOOD AVE
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32305-7244
Practice Address - Country:US
Practice Address - Phone:850-980-4963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No251E00000XAgenciesHome Health
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service