| Name: | Ridgeview Health Services, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 03 Jul 2003 (21 years ago) |
| Entity Number: | 000-229-794 |
| Register Number: | 000229794 |
| County: | Walker |
| Place of Formation: | Walker County |
| Principal Address: | JASPER, AL |
| Registered Office Street Address: | 907 11TH ST NEJASPER, AL 35504 |
| Registered Office Street Address ZIP Code: | 35504 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
Activities
LICENSED NURSING HOME
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265536304 | 2006-09-11 | 2012-03-28 | 903 11TH ST NE, JASPER, AL, 355048821, US | 907 11TH ST NE, JASPER, AL, 355048821, US | |||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 205-221-9111 |
| Fax | 2053871912 |
Authorized person
| Name | MRS. JOETTE KELLEY-BROWN |
| Role | OWNER/ADMINISTRATOR |
| Phone | 2052219111 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 12697 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 332BP3500X - Parenteral & Enteral Nutrition Supplies (DME) |
| License Number | N6401 |
| State | AL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 4753280S |
| State | AL |
| Issuer | BLUE CROSS PROVIDER NUMBE |
| Number | 010685 |
| State | AL |
| Issuer | HEALTHSPRINGS PROVIDER NU |
| Number | 40232 |
| State | AL |
| Name | Role |
|---|---|
| CALDWELL, J FRANK | Agent |
| Name | Role |
|---|---|
| CALDWELL, J FRANK | Incorporator |
| KELLEY, JOE | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
