Healthcare Provider Details

I. General information

NPI: 1417205543
Provider Name (Legal Business Name): STERLING EXCEPTIONAL LEARNING RESOURCES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2012
Last Update Date: 08/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2362 LAWRENCEVILLE HWY SUITE A
DECATUR GA
30033-3175
US

IV. Provider business mailing address

PO BOX 2944
DECATUR GA
30031-2944
US

V. Phone/Fax

Practice location:
  • Phone: 678-510-8373
  • Fax:
Mailing address:
  • Phone: 678-510-8373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. SHANNON D STERLING
Title or Position: DIRECTOR
Credential: M.ED
Phone: 678-510-8383