Provider Demographics
NPI:1710056668
Name:BERRIEN COUNTY BOARD OF EDUCATION PROGRAM FOR EXCEPTIONAL STUDENTS
Entity Type:Organization
Organization Name:BERRIEN COUNTY BOARD OF EDUCATION PROGRAM FOR EXCEPTIONAL STUDENTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:F
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:DOCTOR OF EDUCATION
Authorized Official - Phone:229-686-6567
Mailing Address - Street 1:909A N DAVIS ST.
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31639
Mailing Address - Country:US
Mailing Address - Phone:229-686-6567
Mailing Address - Fax:229-686-6570
Practice Address - Street 1:909A N DAVIS ST.
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:GA
Practice Address - Zip Code:31639
Practice Address - Country:US
Practice Address - Phone:229-686-6567
Practice Address - Fax:229-686-6570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)