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General NPI Number Information
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NPI Number | 1992351431
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Entity Type | Organization
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Legal Business Name | GEORGIA CYBER ACADEMY INC.
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Dates
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Enumeration Date | 08/12/2019
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Last Update Date | 08/12/2019
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Provider Practice Location Address
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Address Line | 1745 PHOENIX BLVD STE 100
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City | ATLANTA
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State | GA
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Zip | 30349-5534
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Country | US
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Telephone | 404-334-4790
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Fax | 404-684-8816
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Provider Business Mailing Address
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Address Line | 1745 PHOENIX BLVD
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City | ATLANTA
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State | GA
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Zip | 30349-5591
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Country | US
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Telephone | 404-334-4790
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Fax | 404-684-8816
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Authorized Official
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Title or Position | DIRECTOR OF SPECIAL PROGRAMS
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Name | KONTEINT REDMON
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Credential |
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Telephone | 404-334-4790
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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 |
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