| Name: | ALABAMA FOUNDATION OF THERAPEUTIC SERVICES, INC. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Non-Profit Corporation |
| Status: | Exists |
| Date of registration: | 14 Jan 2013 (12 years ago) (Companies founded in January 2013) |
| Entity Number: | 000-275-661 |
| Register Number: | 000275661 |
| Place of Formation: | Jefferson County |
Activities
CHARITABLE/RELIGIOUS/EDUCATIONAL/SCIENTIFIC PURPOSES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518466176 | 2018-02-08 | 2018-08-26 | 100 CENTURY PARK S STE 102, BIRMINGHAM, AL, 352263922, US | 100 CENTURY PARK S STE 102, BIRMINGHAM, AL, 35226, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 205-200-5351 |
| Phone | +1 205-656-6554 |
Authorized person
| Name | MR. CARLOS DEWAYNE RICHARDSON |
| Role | CHIEF EXECUTIVE DIRECTOR |
| Phone | 2052005351 |
Taxonomy
| Taxonomy Code | 101YA0400X - Addiction (Substance Use Disorder) Counselor |
| Is Primary | No |
| Taxonomy Code | 101YP2500X - Professional Counselor |
| License Number | 3834 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| License Number | 3834 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| License Number | 3834 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 261QM0855X - Adolescent and Children Mental Health Clinic/Center |
| License Number | 3834 |
| State | AL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 216705 |
| State | AL |
| CAGE number | Status | Type | Established | CAGE Update Date | CAGE Expiration | SAM Expiration | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 6VEC7 | Obsolete | Non-Manufacturer | 2013-03-27 | 2024-02-29 | 2024-02-28 | No data | |||||||||||||||
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| POC | CARLOS D. RICHARDSON |
| Phone | +1 205-200-5351 |
| Fax | +1 888-386-9624 |
| Address | 100 CENTURY PARK SOUTH STE 102, BIRMINGHAM, AL, 35226 3922, UNITED STATES |
Ownership of Offeror Information
| Highest Level Owner | Information not Available |
|---|
| Immediate Level Owner | Information not Available |
|---|
| List of Offerors (0) | Information not Available |
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| Name | Role | Address |
|---|---|---|
| RICHARDSON, CARLOS D | Incorporator | 1529 12TH STREET SWBIRMINGHAM, AL 35211 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
