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Gordon Oaks Convalescent Center, Inc.

Details

Name: Gordon Oaks Convalescent Center, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Dissolved
Date of registration: 23 Jun 1989 (35 years ago) (Companies founded in June 1989)
Date of dissolution: 30 Jul 2014
Entity Number: 000-131-506
Register Number: 000131506
ZIP code: 36609 (Companies in Mobile, 36609)
County: Mobile
Place of Formation: Mobile County
Principal Address: MOBILE, AL
Registered Office Street Address: 6207 COTTAGE HILL RD STE GMOBILE, AL 36609
Authorized Capital: $1,000

Activities HEALTH CARE SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1275639429 2006-09-15 2020-08-22 3151 KNOLLWOOD DR, MOBILE, AL, 366932753, US 3151 KNOLLWOOD DR, MOBILE, AL, 366932753, US

Contacts

Phone +1 251-661-7608
Fax 2516650134

Authorized person

Name MR. TERRY J. MARTIN
Role SECRETARY
Phone 2516660250

Taxonomy

Taxonomy Code 311500000X - Alzheimer Center (Dementia Center)
License Number 12769
State AL
Is Primary No
Taxonomy Code 314000000X - Skilled Nursing Facility
License Number 12642
State AL
Is Primary No

Other Provider Identifiers

Issuer MEDICAID
Number 4757990S
State AL

Agent

Name Role Address
SAAD, LELAND L Agent 6207 COTTAGE HILL RD STE GMOBILE, AL 36609

Incorporator

Name Role
SAAD, JOHN E Incorporator

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State