Provider Demographics
NPI:1114298494
Name:DAWSON COUNTY BOARD OF EDUCATION
Entity Type:Organization
Organization Name:DAWSON COUNTY BOARD OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RUTHERFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-265-3246
Mailing Address - Street 1:517 ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-4317
Mailing Address - Country:US
Mailing Address - Phone:706-265-3246
Mailing Address - Fax:706-216-5720
Practice Address - Street 1:517 ALLEN ST
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-4317
Practice Address - Country:US
Practice Address - Phone:706-265-3246
Practice Address - Fax:706-216-5720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0007750002AMedicaid