| Name: | Cullman County Treatment Center, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 08 Apr 2002 (23 years ago) |
| Entity Number: | 000-222-432 |
| Register Number: | 000222432 |
| County: | Cullman |
| Place of Formation: | Cullman County |
| Principal Address: | CULLMAN, AL |
| Registered Office Street Address: | 1620 LAKEVIEW DRCULLMAN, AL 35055 |
| Registered Office Street Address ZIP Code: | 35055 |
| Authorized Capital: | $1,000 |
Activities
ANY LAWFUL ACTIVITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497258784 | 2018-03-13 | 2018-03-13 | PO BOX 2085, CULLMAN, AL, 350562085, US | 1912 COMMERCE AVE, CULLMAN, AL, 350556150, US | |||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 256-739-5595 |
Authorized person
| Name | LESLIE HOLLAND |
| Role | EXECUTIVE DIRECTOR/OWNER |
| Phone | 2567395595 |
Taxonomy
| Taxonomy Code | 1835P0018X - Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| License Number | 112206 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| License Number | 1195 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 261QM2800X - Methadone Clinic |
| License Number | 1195 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 261QR0405X - Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | 1195 |
| State | AL |
| Is Primary | No |
| Name | Role |
|---|---|
| HEATHERLY, BRENDA H | Agent |
| Name | Role |
|---|---|
| HEATHERLY, BRENDA H | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
