| Camp Academia, Inc. | |
|
907 New Franklin Rd Lagrange GA 30240-1203 | |
| (706) 884-4492 | |
| Not Available |
| Full Name | Camp Academia, Inc. |
|---|---|
| Speciality | Psychologist - Cognitive & Behavioral |
| Location | 907 New Franklin Rd, Lagrange, Georgia |
| Authorized Official Name and Position | Shirley Pennebaker (FOUNDER AND CEO) |
| Authorized Official Contact | 7068844492 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Camp Academia, Inc. 907 New Franklin Rd Lagrange GA 30240-1203 Ph: (706) 884-4492 | Camp Academia, Inc. 907 New Franklin Rd Lagrange GA 30240-1203 Ph: (706) 884-4492 |
| NPI Number | 1952142895 |
|---|---|
| Provider Enumeration Date | 06/04/2024 |
| Last Update Date | 06/04/2024 |
| Certification Date | 06/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952142895 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TB0200X | Psychologist - Cognitive & Behavioral | (NU) | Primary |
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