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Child & Adolescent Associates, P.C.

Details

Name: Child & Adolescent Associates, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Dissolved
Date of registration: 04 Aug 1997 (27 years ago)
Date of dissolution: 12 Dec 2022
Entity Number: 000-189-203
Register Number: 000189203
County: Jefferson
Place of Formation: Jefferson County
Principal Address: BIRMINGHAM, AL
Registered Office Mailing Address: PO BOX 55376BIRMINGHAM, AL 35255-5376
Registered Office Street Address: 1404 MIAMI CIRCLEFORESTDALE, AL 35214
Registered Office Street Address ZIP Code: 35214
Authorized Capital: $100

Activities PRACTICE OF PSYCHIATRY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1134222094 2006-09-06 2020-08-22 1025 MONTGOMERY HWY., SUITE 200, BIRMINGHAM, AL, 352162803, US 1025 MONTGOMERY HWY., SUITE 200, BIRMINGHAM, AL, 352162803, US

Contacts

Phone +1 205-978-7511
Fax 2059787277

Authorized person

Name DR. TERESA MORAN
Role CHILD PSYCHIATRIST/PRESIDENT
Phone 2059787511

Taxonomy

Taxonomy Code 2084P0804X - Child & Adolescent Psychiatry Physician
License Number 4339
State AL
Is Primary Yes

Other Provider Identifiers

Issuer BCBS-FED
Number 515-00269
State AL

Agent

Name Role
MORAN, H T Agent

Incorporator

Name Role
COPE, ALLEN D Incorporator

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State