| Name: | Blossom Residential L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 22 Jun 2012 (12 years ago) |
| Entity Number: | 000-064-970 |
| Register Number: | 000064970 |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Principal Address: | 7659 WILLARD COURTTHEODORE, AL 36582 |
| Principal Address ZIP Code: | 36582 |
Activities
GROUP HOME
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518385277 | 2014-03-31 | 2014-03-31 | PO BOX 774, MOBILE, AL, 366010774, US | 548 MAIN BLVD, PRICHARD, AL, 366104048, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 251-643-8885 |
Authorized person
| Name | MRS. CRYSTAL EIRBY BLACK |
| Role | CEO |
| Phone | 2516438885 |
Taxonomy
| Taxonomy Code | 320900000X - Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BLACK, CRYSTAL E | Agent | 7659 WILLARD COURTTHEODORE, AL 36582 |
| Name | Role | Address |
|---|---|---|
| BLACK, CRYSTAL E | Organizer | 7659 WILLARD COURTTHEODORE, AL 36582 |
Date of last update: 31 Jul 2024
Sources: Alabama Secretary of State
