Fully Corporation

NPI #1689095333 in Cairo, Georgia

Provider Information

NPI Number: 1689095333
Entity Type: Organization
Organization Name: Fully Corporation
Primary Specialty: Foster Care Agency
Enumeration Date: Dec 26, 2013
Last Updated: Dec 26, 2013

Practice Location

Address: 416 JOHNSON RD
City: Cairo
State: Georgia
ZIP Code: 39828-8414
Phone: (229) 872-3113

Authorized Official

Name: MRS. PETULA LORAINE GORDON
Title: PROVIDER
Phone: (229) 327-1982

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Foster Care Agency	253J00000X	Primary

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