| Name: | Providence Family Psychiatry, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 30 Sep 2005 (19 years ago) |
| Date of dissolution: | 11 Jun 2018 |
| Entity Number: | 000-243-617 |
| Register Number: | 000243617 |
| County: | Shelby |
| Place of Formation: | Shelby County |
| Registered Office Street Address: | 1800 PROVIDENCE PARK STE 250HOOVER, AL 35242 |
| Registered Office Street Address ZIP Code: | 35242 |
| Principal Address: | HOOVER, AL |
| Authorized Capital: | $100 |
Activities
PSYCHIATRY MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124177936 | 2007-01-09 | 2020-08-22 | 1800 PROVIDENCE PARK, SUITE 250, BIRMINGHAM, AL, 352424697, US | 1800 PROVIDENCE PARK, SUITE 250, BIRMINGHAM, AL, 352424697, US | |||||||||||||||||
|
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| Phone | +1 205-949-0960 |
Authorized person
| Name | DR. PETER MORRIS SIMS |
| Role | PRESIDENT |
| Phone | 2059490960 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | 15894 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| SIMS, PETER | Agent |
| Name | Role | Address |
|---|---|---|
| SMITH, ELIZABETH A | Incorporator | 2711 CENTERVILLE ROAD SUITE 400WILMINGTON, DE 19808 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
