| Name: | ALABAMA BEHAVIORAL CARE, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 10 Jan 2014 (11 years ago) (Companies founded in January 2014) |
| Entity Number: | 000-294-789 |
| Register Number: | 000294789 |
| ZIP code: | 35226 (Companies in Jefferson, 35226) |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | 2402 HUNTINGTON GLEN DRIVEBIRMINGHAM, AL 35226 |
Activities
HEALTH CARE SERVICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003371865 | 2019-02-06 | 2019-02-06 | 2402 HUNTINGTON GLEN DR, BIRMINGHAM, AL, 352261997, US | 1530 2ND AVE N, BIRMINGHAM, AL, 352031825, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 205-516-8699 |
| Fax | 2052385158 |
Authorized person
| Name | DR. GRAHAM OSARETIN OSULA |
| Role | CEO/SOLE PROPRIETOR/MEDICAL DIRECTO |
| Phone | 2055168699 |
Taxonomy
| Taxonomy Code | 101Y00000X - Counselor |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1528226479 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| OSULA, GRAHAM | Agent | 2402 HUNTINGTON GLEN DRIVEBIRMINGHAM, AL 35226 |
| Name | Role | Address |
|---|---|---|
| OSULA, GRAHAM | Organizer | 2402 HUNTINGTON GLEN DRIVEBIRMINGHAM, AL 35226 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
