| Name: | Forum Green, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 24 Oct 1978 (46 years ago) (Companies founded in October 1978) |
| Entity Number: | 000-053-642 |
| Register Number: | 000053642 |
| Historical Names: |
Limestone Health Facility, Inc.
|
| Place of Formation: | Limestone County |
| Authorized Capital: | $4,500 |
| Paid Share Capital: | $4,500 |
Activities
MEDICAL SERVICES CLINICS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851310940 | 2006-07-19 | 2015-02-09 | 1600 WEST HOBBS STREET, ATHENS, AL, 35611, US | 1600 WEST HOBBS STREET, ATHENS, AL, 35611, US | |||||||||||||||||||||||||||||||||
|
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| Phone | +1 256-232-3461 |
| Fax | 2562321767 |
Authorized person
| Name | MR. DAVID A. HUNT |
| Role | ADMINISTRATOR |
| Phone | 2562323461 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 475670 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | N4202 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 475670 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| HUNT, BILL R | Director | No data |
| HUNT, GRACE | Director | No data |
| HUNT, CARL | Director | No data |
| HUNT, DAVID | Director | 6121 LINDHOLM DRIVE SOUTHMOBILE, AL 36693 |
| FORET, CAROLE | Director | No data |
| KAYSER, CLAIRE | Director | No data |
| Name | Role |
|---|---|
| HUNT, BILL R | Incorporator |
| HUNT, GRACE D | Incorporator |
| MEAGHER, J STEPHEN | Incorporator |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 1986-11-26 | Name Change | Limestone Health Facility, Inc. | Forum Green, Inc. |
Date of last update: 31 Jul 2024
Sources: Alabama Secretary of State
