| Classroom21 | |
|
527 Railroad St Fort Valley GA 31030-2700 | |
| (478) 396-5489 | |
| Not Available |
| Full Name | Classroom21 |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 527 Railroad St, Fort Valley, Georgia |
| Authorized Official Name and Position | Kenneth Wayne O'bara (CO-FOUNDER) |
| Authorized Official Contact | 9122812251 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Classroom21 527 Railroad St Fort Valley GA 31030-2700 Ph: (478) 396-5489 | Classroom21 527 Railroad St Fort Valley GA 31030-2700 Ph: (478) 396-5489 |
| NPI Number | 1609581800 |
|---|---|
| Provider Enumeration Date | 01/23/2023 |
| Last Update Date | 01/23/2023 |
| Certification Date | 01/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609581800 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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