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Organization
FULLER HOMES LLC
Active
Organization
FULLER HOMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YVETTE RENEE FULLER LPN (EXECUTIVE DIRECTOR/ AGENCY NURSE)
(256) 221-0041
Entity
Organization
Contact information
Practice address
102 POPULUS DR, HARVEST, AL 35749-4802
(256) 221-0041
(256) 937-2002
Mailing address
1808 SCOBEE AVE SW, DECATUR, AL 35603-2407
(256) 221-0041
(256) 937-2002
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/02/2017
Last updated
08/02/2017
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