# MARY LORETTA HOUSE, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396037420
- **Authorized official:** MS. MARY STEEDMAN (REGISTERD AGENT)
- **Authorized official phone:** (678) 390-2682

## Contact information

- **Practice address:** 2133 LAWRENCEVILLE SUWANEE RD, \#12-136, SUWANEE, GA 30024-2648
- **Practice address phone:** (678) 390-2682
- **Mailing address:** 2133 LAWRENCEVILLE SUWANEE RD, \#12-136, SUWANEE, GA 30024-2648
- **Mailing address phone:** (678) 390-2682

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 09081085 | GA | Yes |

## Other

- **Enumeration date:** 05/09/2011
- **Last updated:** 01/12/2012