Organization
MARY LORETTA HOUSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY STEEDMAN (REGISTERD AGENT)
(678) 390-2682
Entity
Organization
Contact information
Practice address
2133 LAWRENCEVILLE SUWANEE RD, #12-136, SUWANEE, GA 30024-2648
(678) 390-2682
Mailing address
2133 LAWRENCEVILLE SUWANEE RD, #12-136, SUWANEE, GA 30024-2648
(678) 390-2682
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
09081085
GA
Other
Enumeration date
05/09/2011
Last updated
01/12/2012
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