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Wellspring Christian Clinic, Inc.

Details

Name: Wellspring Christian Clinic, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Exists
Date of registration: 19 Aug 2003 (21 years ago) (Companies founded in August 2003)
Entity Number: 000-230-631
Register Number: 000230631
ZIP code: 35223 (Companies in Jefferson, 35223)
County: Jefferson
Place of Formation: Jefferson County
Principal Address: BIRMINGHAM, AL
Registered Office Street Address: 200 OFFICE PARK DR STE 325BIRMINGHAM, AL 35223
Authorized Capital: $1,000

Activities PROVIDE COUNSELING SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1962526301 2007-03-19 2012-04-06 3104 BLUE LAKE DR, SUITE 100, VESTAVIA, AL, 352432345, US 3104 BLUE LAKE DR, SUITE 100, VESTAVIA, AL, 352432345, US

Contacts
Phone +1 205-977-3003
Fax 2059773939

Authorized person
Name DR. THOMAS AL SAUNDERS JR.
Role DIRECTOR
Phone 2059773003

Taxonomy
Taxonomy Code 103TC0700X - Clinical Psychologist
License Number 889
State AL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
WELLSPRING CHRISTIAN CLINIC, INC. 401(K) PROFIT SHARING PLAN 2023 134261492 2024-09-27 WELLSPRING CHRISTIAN CLINIC, INC. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 813000
Sponsor’s telephone number 2059773003
Plan sponsor’s address 3104 BLUE LAKE DRIVE, SUITE 100, BIRMINGHAM, AL, 35243

Signature of
Role Plan administrator
Date 2024-09-27
Name of individual signing THOMAS AL SAUNDERS, JR. PSY.D
Valid signature Filed with authorized/valid electronic signature
WELLSPRING CHRISTIAN CLINIC, INC. 401(K) PROFIT SHARING PLAN 2022 134261492 2023-01-27 WELLSPRING CHRISTIAN CLINIC, INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 813000
Sponsor’s telephone number 2059773003
Plan sponsor’s address 3104 BLUE LAKE DRIVE, SUITE 100, BIRMINGHAM, AL, 35243

Signature of
Role Plan administrator
Date 2023-01-27
Name of individual signing THOMAS AL SAUNDERS, JR. PSY.D
WELLSPRING CHRISTIAN CLINIC, INC. 401(K) PROFIT SHARING PLAN 2021 134261492 2022-09-12 WELLSPRING CHRISTIAN CLINIC, INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 813000
Sponsor’s telephone number 2059773003
Plan sponsor’s address 3104 BLUE LAKE DRIVE, SUITE 100, BIRMINGHAM, AL, 35243

Signature of
Role Plan administrator
Date 2022-09-12
Name of individual signing THOMAS AL SAUNDERS, JR. PSY.D
WELLSPRING CHRISTIAN CLINIC, INC. 401(K) PROFIT SHARING PLAN 2020 134261492 2021-07-02 WELLSPRING CHRISTIAN CLINIC, INC. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 813000
Sponsor’s telephone number 2059773003
Plan sponsor’s address 3104 BLUE LAKE DRIVE, SUITE 100, BIRMINGHAM, AL, 35243

Signature of
Role Plan administrator
Date 2021-07-02
Name of individual signing THOMAS AL SAUNDERS, JR. PSY.D
WELLSPRING CHRISTIAN CLINIC, INC. 401(K) PROFIT SHARING PLAN 2019 134261492 2020-06-24 WELLSPRING CHRISTIAN CLINIC, INC. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 813000
Sponsor’s telephone number 2059773003
Plan sponsor’s address 3104 BLUE LAKE DRIVE, SUITE 100, BIRMINGHAM, AL, 35243

Signature of
Role Plan administrator
Date 2020-06-24
Name of individual signing THOMAS AL SAUNDERS, JR. PSY.D
WELLSPRING CHRISTIAN CLINIC, INC. 401(K) PROFIT SHARING PLAN 2018 134261492 2019-10-15 WELLSPRING CHRISTIAN CLINIC, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 813000
Sponsor’s telephone number 2059773003
Plan sponsor’s address 3104 BLUE LAKE DRIVE, SUITE 100, BIRMINGHAM, AL, 35243

Signature of
Role Plan administrator
Date 2019-10-15
Name of individual signing THOMAS AL SAUNDERS, JR. PSY.D
WELLSPRING CHRISTIAN CLINIC, INC. 401(K) PROFIT SHARING PLAN 2017 134261492 2018-10-15 WELLSPRING CHRISTIAN CLINIC, INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 813000
Sponsor’s telephone number 2059773003
Plan sponsor’s address 3104 BLUE LAKE DRIVE, SUITE 100, BIRMINGHAM, AL, 35243

Signature of
Role Plan administrator
Date 2018-10-15
Name of individual signing THOMAS AL SAUNDERS, JR. PSY.D
WELLSPRING CHRISTIAN CLINIC, INC. 401(K) PROFIT SHARING PLAN 2016 134261492 2017-10-16 WELLSPRING CHRISTIAN CLINIC, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 813000
Sponsor’s telephone number 2059773003
Plan sponsor’s address 3104 BLUE LAKE DRIVE, SUITE 100, BIRMINGHAM, AL, 35243

Signature of
Role Plan administrator
Date 2017-10-16
Name of individual signing THOMAS AL SAUNDERS, JR. PSY.D
WELLSPRING CHRISTIAN CLINIC, INC. 401(K) PROFIT SHARING PLAN 2015 134261492 2016-09-22 WELLSPRING CHRISTIAN CLINIC, INC. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 813000
Sponsor’s telephone number 2059773003
Plan sponsor’s address 3104 BLUE LAKE DRIVE, SUITE 100, BIRMINGHAM, AL, 35243
WELLSPRING CHRISTIAN CLINIC, INC. 401(K) PROFIT SHARING PLAN 2014 134261492 2015-09-25 WELLSPRING CHRISTIAN CLINIC, INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 813000
Sponsor’s telephone number 2059773003
Plan sponsor’s address 3104 BLUE LAKE DRIVE, SUITE 100, BIRMINGHAM, AL, 35243

Incorporator

Name Role
DAZZIO, P THOMAS Incorporator

Agent

Name Role
SAUNDERS, THOMAS AL Agent

Related by officers

DAZZIO, P THOMAS

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Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State

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