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Leatrice Heidelberg
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Lehigh Acres, Florida
NPI 1407617053

Leatrice Heidelberg is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Lehigh Acres, FL. Leatrice Heidelberg practices in Lehigh Acres, FL. The NPI Number for Leatrice Heidelberg is 1407617053 and holds a License No. (Florida).

The current practice location address for Leatrice Heidelberg is 501 Michael Ave, Lehigh Acres, FL and can be reached out via phone at 239-645-8297.

Location: 501 Michael Ave, Lehigh Acres, FL, 33972-7684
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1407617053
Provider Name
Leatrice Heidelberg
Credential
Provider Entity Type
Individual
Gender
Female
Address
501 Michael Ave, Lehigh Acres, FL, 33972-7684
Phone Number
239-645-8297
Fax Number
Provider Enumeration Date
01/22/2024
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
501 Michael Ave
City
Lehigh Acres
State
Florida
Zip
33936-1043
Phone Number
239-645-8297
Fax Number
person
Provider Business Mailing Address Details
Address
501 Michael Ave
City
Lehigh Acres
State
Florida
Zip
33936-1043
Phone Number
239-645-8297
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
(Florida)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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