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Individual

ELIZABETH STAPLETON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4628 25TH ST SW, LEHIGH ACRES, FL 33973-6161
(484) 773-3236
Mailing address
4628 25TH ST SW, LEHIGH ACRES, FL 33973-6161
(484) 773-3236

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
385H00000X
Respite Care

Other

Enumeration date
12/23/2019
Last updated
12/23/2019
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