NPI 1033506712

St. Mary's Independent Living Extensions

Organisation Developmentally Disabled Services Day Training Agency Lawrenceville, GA

Practice location

Address: 120 Gloster Rd NW STE 3, Lawrenceville, GA 30044-4479
Phone: (770) 279-5115
Fax: (770) 923-2059

Authorised official

Name: Paul Pieper
Title: Executive Director
Phone: (770) 279-5115

Registered specialties

Developmentally Disabled Services Day Training Agency Primary

Agencies Taxonomy 251C00000X Licence 067-R-0388 (GA)

Other Day Training, Developmentally Disabled Services providers in Georgia →

Registry record

NPI: 1033506712
Entity type: Organization
NPI issued: 21 Apr 2015
Record last updated: 21 Apr 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.