Fully Corporation

Primary specialty

Foster Care AgencyTaxonomy code 253J00000X

Legal business name

FULLY CORPORATION

Practice address

416 Johnson Rd
Cairo, GA 39828-8414

Phone

(229) 872-3113

Fax

(229) 872-3642

NPI assigned

Dec 26, 2013

Last updated

Dec 26, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Petula Loraine Gordon

Title

Provider

Phone

(229) 327-1982

Specialties & licenses 1

Addresses

Other names 1

• Faithfulness ,Understanding, Learning & Loving Youth Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1388016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388016000000",
    "number": "1689095333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 57",
            "city": "CALVARY",
            "state": "GA",
            "postal_code": "398290057",
            "telephone_number": "229-872-3113",
            "fax_number": "229-872-3642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 JOHNSON RD",
            "city": "CAIRO",
            "state": "GA",
            "postal_code": "398288414",
            "telephone_number": "229-872-3113",
            "fax_number": "229-872-3642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-26",
        "last_updated": "2013-12-26",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "PETULA",
        "authorized_official_middle_name": "LORAINE",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "229-327-1982",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Faithfulness ,Understanding, Learning & Loving Youth",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Foster Care Agency in Cairo, GA
• Providers in Cairo, GA by specialty
• Foster Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.