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General NPI Number Information
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NPI Number | 1710056668
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Entity Type | Organization
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Legal Business Name | BERRIEN COUNTY BOARD OF EDUCATION PROGRAM FOR EXCEPTIONAL STUDENTS
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 909A N DAVIS ST.
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City | NASHVILLE
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State | GA
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Zip | 31639
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Country | US
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Telephone | 229-686-6567
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Fax | 229-686-6570
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Provider Business Mailing Address
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Address Line | 909A N DAVIS ST.
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City | NASHVILLE
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State | GA
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Zip | 31639
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Country | US
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Telephone | 229-686-6567
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Fax | 229-686-6570
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Authorized Official
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Title or Position | PROGRAM ADMINISTRATOR
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Name | DR. DORIS F MANN
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Credential | DOCTOR OF EDUCATION
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Telephone | 229-686-6567
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State | GA
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