| Name: | Hospice of Tennessee Valley, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 04 Apr 2002 (23 years ago) |
| Entity Number: | 000-222-148 |
| Register Number: | 000222148 |
| County: | Lauderdale |
| Place of Formation: | Lauderdale County |
| Principal Address: | FLORENCE, AL |
| Registered Office Street Address: | 200 WEST TENNESSEE STFLORENCE, AL 35630 |
| Registered Office Street Address ZIP Code: | 35630 |
| Authorized Capital: | $10 |
Activities
PROVIDE IN HOME HOSPICE CARE TO THE TERMINALLY ILL
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619083391 | 2006-08-22 | 2008-11-21 | 200 WEST TENNESSEE STREET, FLORENCE, AL, 35630, US | 200 WEST TENNESSEE STREET, FLORENCE, AL, 35630, US | |||||||||||||||||||||||||
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| Phone | +1 256-767-1322 |
| Fax | 2567180077 |
Authorized person
| Name | MR. JOHN BLAKE EDWARDS |
| Role | ADMINISTRATOR |
| Phone | 2567671322 |
Taxonomy
| Taxonomy Code | 251G00000X - Community Based Hospice Care Agency |
| License Number | 12844 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | PIC1592E |
| State | AL |
| Name | Role | Address |
|---|---|---|
| EDWARDS, BLAKE | Agent | 606 BUTTERFLY DRMONTGOMERY, AL 36117 |
| Name | Role | Address |
|---|---|---|
| EDWARDS, BLAKE | Incorporator | 606 BUTTERFLY DRMONTGOMERY, AL 36117 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
