| Name: | Talladega Healthcare Center, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 07 Aug 1991 (33 years ago) |
| Entity Number: | 000-144-602 |
| Register Number: | 000144602 |
| County: | Montgomery |
| Place of Formation: | Jefferson County |
| Principal Address: | BIRMINGHAM, AL |
| Registered Office Street Address: | 100 PERRY HILL ROADMONTGOMERY, AL 36109 |
| Registered Office Street Address ZIP Code: | 36109 |
| Authorized Capital: | $5,000 |
Activities
NURSING HOME
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHK4NNBB6QG5 | 2025-01-29 | 616 CHAFFEE ST, TALLADEGA, AL, 35160, 2809, USA | 616 CHAFFEE STREET, TALLADEGA, AL, 35160, USA | |||||||||||||||||||||||||||||||||||||
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| Congressional District | 03 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2024-02-01 |
| Initial Registration Date | 2021-08-04 |
| Entity Start Date | 1991-08-02 |
| Fiscal Year End Close Date | Jun 30 |
Service Classifications
| NAICS Codes | 623110 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | TAMMY STEPHENSON |
| Address | 616 CHAFFEE STREET, TALLADEGA, AL, 35160, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | TAMMY STEPHENSON |
| Address | 616 CHAFFEE STREET, TALLADEGA, AL, 35160, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932281615 | 2006-10-20 | 2012-01-11 | 616 CHAFFEE ST, TALLADEGA, AL, 351602809, US | 616 CHAFFEE ST, TALLADEGA, AL, 351602809, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 256-362-4197 |
| Fax | 2563620726 |
Authorized person
| Name | MS. PATTI WALLACE |
| Role | CHAIRMAN OF THE BOARD |
| Phone | 3342739002 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 12681 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 47-50210S |
| State | AL |
| Issuer | MEDICAID |
| Number | 009936787 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| WALLACE, PATTI | Agent | 100 PERRY HILL ROADMONTGOMERY, AL 36109 |
| Name | Role | Address |
|---|---|---|
| STEPHENSON, JACK P JR | Incorporator | 420 N 20TH STREET STE 3400BIRMINGHAM, AL 35203 |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DELIVERY ORDER | AWARD | 36C24724K0044 | 2022-11-01 | 2024-05-31 | 2026-11-30 | |||||||||||||||||||||||||
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| Obligated Amount | 157713.99 |
| Current Award Amount | 157713.99 |
| Potential Award Amount | 157713.99 |
Description
| Title | EXPRESS REPORT: NOV 23 - MAY 24 |
| NAICS Code | 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES) |
| Product and Service Codes | Q402: MEDICAL- NURSING HOME CARE CONTRACTS |
Recipient Details
| Recipient | TALLADEGA HEALTHCARE CENTER, INC. |
| UEI | CHK4NNBB6QG5 |
| Recipient Address | UNITED STATES, 616 CHAFFEE ST, TALLADEGA, TALLADEGA, ALABAMA, 351602809 |
| Unique Award Key | CONT_IDV_36C24722D0007_3600 |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Award Amounts
| Obligated Amount | 0.00 |
| Potential Award Amount | 2702127.67 |
Description
| Title | NURSING HOME SERVICES |
| NAICS Code | 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES) |
| Product and Service Codes | Q402: NURSING HOME, LONG-TERM & ADULT DAY CARE SERVICES |
Recipient Details
| Recipient | TALLADEGA HEALTHCARE CENTER, INC. |
| UEI | CHK4NNBB6QG5 |
| Recipient Address | UNITED STATES, 616 CHAFFEE ST, TALLADEGA, TALLADEGA, ALABAMA, 351602809 |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
