| Name: | Mercy Life of Alabama |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Non-Profit Corporation |
| Status: | Exists |
| Date of registration: | 18 Jan 2011 (14 years ago) |
| Entity Number: | 000-000-219 |
| Register Number: | 000000219 |
| County: | Mobile |
| Place of Formation: | Baldwin County |
| Registered Office Street Address: | 2 NORTH JACKSON STREET SUITE 605MONTGOMERY, AL 36104 |
| Registered Office Street Address ZIP Code: | 36104 |
| Principal Address: | 2900 SPRINGHILL AVENUEMOBILE, AL 36607 |
| Principal Address ZIP Code: | 36607 |
Activities
PROMOTE/PROVIDE HEALTH CARE SERVICES TO OLDER ADULTS
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HZN5B6NLAK25 | 2024-11-29 | 2900 SPRINGHILL AVENUE, MOBILE, AL, 36607, 1822, USA | 2900 SPRINGHILL AVENUE, MOBILE, AL, 36607, USA | |||||||||||||||||||||||||||||||||||||||||||
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| URL | www.mercylifeal.com |
| Division Name | MERCY LIFE OF ALABAMA |
| Congressional District | 01 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2023-12-04 |
| Initial Registration Date | 2016-06-13 |
| Entity Start Date | 2012-01-02 |
| Fiscal Year End Close Date | Jun 30 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | VANESSA BRADLEY |
| Role | FINANCE MANAGER |
| Address | 2900 SPRINGHILL AVENUE, MOBILE, AL, 36607, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | VANESSA BRADLEY |
| Role | FINANCE MANAGER |
| Address | 2900 SPRINGHILL AVENUE, MOBILE, AL, 36607, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952609059 | 2011-03-14 | 2011-11-07 | PO BOX 1090, DAPHNE, AL, 365261090, US | 2900 SPRINGHILL AVE, MOBILE, AL, 366071822, US | |||||||||||||||||
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| Phone | +1 251-287-8420 |
| Fax | 2516214234 |
Authorized person
| Name | DIANE LANCASTER |
| Role | EXECUTIVE DIRECTOR |
| Phone | 2516214452 |
Taxonomy
| Taxonomy Code | 251T00000X - PACE Provider Organization |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FORSTROM, JOANNA | Director | 101 VILLA DRDAPHNE, AL 36526 |
| DUBOSE, LEEVONES | Director | 101 VILLA DRDAPHNE, AL 36526 |
| EADS, JOHN | Director | 101 VILLA DRDAPHNE, AL 36526 |
| OBERKIRCH, CAROLYN | Director | 101 VILLA DRDAPHNE, AL 36526 |
| HANKS, ROMA | Director | 101 VILLA DRDAPHNE, AL 36526 |
| PHILLIPS, EUGENE | Director | 101 VILLA DRDAPHNE, AL 36526 |
| ANDERSON, TOMMIE | Director | 1304 STORE CREST DRIVEBIRMINGHAM, AL 35235 |
| HARRISON, CAROL | Director | 144 LAKEVIEW LOOPDAPHNE, AL 36526 |
| BELL, JAKE | Director | 315 BOWLING GREEN DRMONTGOMERY, AL 36109 |
| Name | Role | Address |
|---|---|---|
| BELL, JAKE | Incorporator | 315 BOWLING GREEN DRMONTGOMERY, AL 36109 |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 6190 POWERS FERRY RD STE 600ATLANTA, GA 30339 |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2021-12-22 | Name Merged | No data | Mercy Medical, A Corporation |
Date of last update: 29 Jul 2024
Sources: Alabama Secretary of State
