ST. MARY'S INDEPENDENT LIVING EXTENSIONS
NPI 1033506712
Day Training, Developmentally Disabled Services in Lawrenceville, GA

NPI Status: Active since April 21, 2015

Contact Information

120 GLOSTER RD NW STE 3
LAWRENCEVILLE, GA
ZIP 30044
Phone: (770) 279-5115
Fax: (770) 923-2059

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About ST. MARY'S INDEPENDENT LIVING EXTENSIONS

This page provides the complete NPI Profile along with additional information for St. Mary's Independent Living Extensions, a provider established in Lawrenceville, Georgia operating as a Day Training, Developmentally Disabled Services. The healthcare provider is registered in the NPI registry with number 1033506712 assigned on April 2015. The practitioner's primary taxonomy code is 251C00000X with license number 067-R-0388 (GA). The provider is registered as an organization and their NPI record was last updated 10 years ago. The authorized official of this NPI record is Paul Pieper (Executive Director)

NPI
1033506712
Provider Name
ST. MARY'S INDEPENDENT LIVING EXTENSIONS
Entity Type
Organization
Location Address
120 GLOSTER RD NW STE 3 LAWRENCEVILLE, GA 30044
Location Phone
(770) 279-5115
Location Fax
(770) 923-2059
Mailing Address
120 GLOSTER RD NW STE 3 LAWRENCEVILLE, GA 30044
Mailing Phone
(770) 279-5115
Mailing Fax
(770) 923-2059
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-21-2015
Last Update Date
04-21-2015
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Day Training, Developmentally Disabled Services

Taxonomy Code
251C00000X
Type
Agencies
License No.
067-R-0388
License State
GA
Taxonomy Description
These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

PAUL PIEPER

Authorized Official Title
EXECUTIVE DIRECTOR
Authorized Official Phone
(770) 279-5115

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
779876528AMEDICAID (05)GA 
779876528BMEDICAID (05)GA 

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1033506712
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20631001272
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 6 + 3 + 1 + 0 + 0 + 1 + 2 + 7 + 2 + 24 = 48
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 48 = 22

The NPI number 1033506712 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1033506712, enumerated in the NPI registry as an "organization" on April 21, 2015

The provider is located at 120 Gloster Rd Nw Ste 3 Lawrenceville, Ga 30044 and the phone number is (770) 279-5115

This medical organization specializes in Day Training, Developmentally Disabled Services with taxonomy code 251C00000X

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

This NPI record was last updated on April 21, 2015. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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