NPI 1689095333

Fully Corporation

Organisation Foster Care Agency Cairo, GA

Practice location

Address: 416 Johnson Rd, Cairo, GA 39828-8414
Phone: (229) 872-3113
Fax: (229) 872-3642
Mailing address: PO Box 57, Calvary, GA 39829-0057

Authorised official

Name: Petula Loraine Gordon
Title: Provider
Phone: (229) 327-1982

Registered specialties

Foster Care Agency Primary

Agencies Taxonomy 253J00000X

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Registry record

NPI: 1689095333
Entity type: Organization
NPI issued: 26 Dec 2013
Record last updated: 26 Dec 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.