| Name: | Centre Home Care, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 01 Mar 2006 (19 years ago) (Companies founded in March 2006) |
| Entity Number: | 000-246-001 |
| Register Number: | 000246001 |
| Historical Names: |
Centre Home Care Corporation
|
| ZIP code: | 36104 (Companies in Montgomery, 36104) |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Registered Office Street Address: | 2 NORTH JACKSON STREET, SUITE 605MONTGOMERY, AL 36104 |
Activities
OPERATE/MANAGE VARIOUS HEALTH CARE FACILITIES
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FX5LGQRNP5T8 | 2024-11-08 | 104C NORTHWOOD DR STE A-1, CENTRE, AL, 35960, 1017, USA | P O BOX 51266, LAFAYETTE, LA, 70505, 1266, USA | |||||||||||||||||||||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Congressional District | 03 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2023-11-28 |
| Initial Registration Date | 2023-11-09 |
| Entity Start Date | 2018-04-01 |
| Fiscal Year End Close Date | Dec 31 |
Service Classifications
| NAICS Codes | 621610 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | TAMMY LANTHIER |
| Role | REVENUE CYCLE |
| Address | 901 HUGH WALLIS ROAD SOUTH, LAFAYETTE, LA, 70508, 2511, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | DANA NELSON |
| Role | LICENSURE PARALEGAL |
| Address | 901 HUGH WALLIS ROAD SOUTH, LAFAYETTE, LA, 70508, 2511, USA |
| Title | ALTERNATE POC |
| Name | MIA GUIDRY |
| Role | LICENSURE PARALEGAL |
| Address | 901 HUGH WALLIS ROAD SOUTH, LAFAYETTE, LA, 70508, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245261502 | 2006-07-05 | 2024-05-24 | PO BOX 51266, LAFAYETTE, LA, 705051266, US | 104C NORTHWOOD DR STE A-1, CENTRE, AL, 359601017, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 337-233-1307 |
| Fax | 3374434154 |
| Phone | +1 256-927-1144 |
| Fax | 2569278068 |
Authorized person
| Name | JOSHUA L PROFFITT |
| Role | PRESIDENT |
| Phone | 3372331307 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BC/ BS NURSING |
| Number | 510 43642 |
| State | AL |
| Issuer | MEDICAID |
| Number | CHE7094 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| C T CORPORATION SYSTEM | Agent | 2 NORHT JACKSON STREET SUITE 605MONTGOMERY, AL 36104 |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2016-09-28 | Name Change | Centre Home Care Corporation | Centre Home Care, LLC |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
