Healthcare Provider Details

I. General information

NPI: 1770654287
Provider Name (Legal Business Name): WHITE COUNTY SCHOOL SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 N BROOKS ST
CLEVELAND GA
30528-1117
US

IV. Provider business mailing address

113 N BROOKS ST
CLEVELAND GA
30528-1117
US

V. Phone/Fax

Practice location:
  • Phone: 706-865-4227
  • Fax: 706-865-5290
Mailing address:
  • Phone: 706-865-4227
  • Fax: 706-865-5290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateGA

VIII. Authorized Official

Name: MR. RANDALL JARRARD
Title or Position: SPECIAL DIRECTOR
Credential:
Phone: 706-865-4227