| Name: | Shelby Ridge Acquisition Corporation |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 12 Nov 2004 (20 years ago) (Companies founded in November 2004) |
| Entity Number: | 000-238-228 |
| Register Number: | 000238228 |
| ZIP code: | 36109 (Companies in Montgomery, 36109) |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Principal Address: | MONTGOMERY, AL |
| Registered Office Street Address: | 100 PERRY HILL RDMONTGOMERY, AL 36109 |
| Authorized Capital: | $2,000 |
Activities
OWN/MANAGE/OPERATE SHELBY RIDGE NURSING HOME
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710938998 | 2006-05-13 | 2012-01-11 | 881 3RD ST NE, ALABASTER, AL, 350078954, US | 881 3RD ST NE, ALABASTER, AL, 350078954, US | |||||||||||||||||||||||||||||||||||
|
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| Phone | +1 205-620-8500 |
| Fax | 2056208553 |
Authorized person
| Name | MRS. TAMMY MOCK STEPHENSON |
| Role | CFO |
| Phone | 3342739002 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 12676 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009936913 |
| State | AL |
| Issuer | MEDICAID |
| Number | 47-58040S |
| State | AL |
| Name | Role | Address |
|---|---|---|
| MANCUSO, THOMAS G | Incorporator | 401 MADISON AVENUEMONTGOMERY, AL 36104 |
| Name | Role | Address |
|---|---|---|
| SCHMIDT, CHRISTOPHER | Agent | 100 PERRY HILL ROADMONTGOMERY, AL 36109 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
