NPI 1477180883
A Certain Lad Ministries INC.
Practice location
- Address
- 693 Shannon Way, Lawrenceville, GA 30044-6310
- Phone
- (678) 698-5227
Authorised official
- Name
- Cory Jermaine Marshall
- Title
- Chief Executive Officer
- Phone
- (770) 282-4273
Registered specialties (4)
Assisted Living Facility
Primary
Assisted Living Facility (Mental Illness)
Assisted Living Facility (Behavioral Disturbances)
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Registry record
- NPI
- 1477180883
- Entity type
- Organization
- NPI issued
- 25 Mar 2020
- Record last updated
- 25 Mar 2020
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.