| Name: | Valley Family Care, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 30 Nov 2011 (13 years ago) |
| Entity Number: | 000-032-394 |
| Register Number: | 000032394 |
| County: | Limestone |
| Place of Formation: | Limestone County |
| Registered Office Street Address: | 12060 COUNTY LINE RD STE DMADISON, AL 35756 |
| Registered Office Street Address ZIP Code: | 35756 |
Activities
GENERAL HEALTH & MONOR MEDICAL CARE MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558648311 | 2011-11-08 | 2011-11-08 | 12060 COUNTY LINE RD, SUITE D, MADISON, AL, 357562003, US | 12060 COUNTY LINE RD, SUITE D, MADISON, AL, 357562003, US | |||||||||||||||||||||||||||||||
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| Phone | +1 256-651-3062 |
Authorized person
| Name | REBECCA RAE DICKERSON |
| Role | NURSE PRACTITIONER |
| Phone | 2566513062 |
Taxonomy
| Taxonomy Code | 261QR1300X - Rural Health Clinic/Center |
| License Number | 1-093181 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| License Number | 1-093181 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 110708 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| DICKERSON, REBECCA | Agent | 12060 COUNTY LINE RD STE DMADISON, AL 35756 |
| Name | Role | Address |
|---|---|---|
| DICKERSON, REBECCA | Organizer | 12060 COUNTY LINE RD STE DMADISON, AL 35756 |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
