Individual provider · Type 1 NPI
Derrick Cornelius Fullwood
Community/Behavioral Health Agency · Clinton, NC
Practice location
4442 Bonnetsville Rd
Clinton, NC 28328-1001
Mailing address
4337 Lake Ridge Dr
Raleigh, NC 27604-3469
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Community/Behavioral Health Agency Primary | 251S00000X | None listed |
Community/Behavioral Health Agency: A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day suppo…
About NPI 1154656338
Derrick Cornelius Fullwood's National Provider Identifier is 1154656338, issued on Oct 6, 2009. The primary taxonomy on file is Community/Behavioral Health Agency (251S00000X), and the practice location is in Clinton, NC. The record was last updated on Oct 6, 2009.