St Mary's Independent Living Extensions
St Mary's Independent Living Extensions is a Developmentally Disabled Services Day Training Agency in Lawrenceville, Georgia. Licensed in Georgia. Registered with an NPI since 2015.
- Licensed in
- GA
- In the registry since
- 2015
Practice location Address checks out
120 Gloster Rd NW Ste 3Lawrenceville, GA 30044-4479
Phone: (770) 279-5115
Fax: (770) 923-2059
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Developmentally Disabled Services Day Training Agency (primary) | Taxonomy 251C00000X · Licence 067-R-0388 (GA) |
|---|
Record details
| NPI number | 1033506712 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Paul Pieper — Executive Director · (770) 279-5115 |
| NPI enumerated | April 21, 2015 |
| Last updated in NPPES | April 21, 2015 |
| Mailing address | 120 Gloster Rd Nw Ste 3, Lawrenceville, GA 30044-4479 |
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