| Name: | Kolbe Clinic, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 02 Oct 2014 (10 years ago) |
| Entity Number: | 000-319-552 |
| Register Number: | 000319552 |
| ZIP code: | 35244 |
| County: | Jefferson |
| Place of Formation: | Shelby County |
| Principal Address: | 1239 COUNTRY CLUB CIRCLEHOOVER, AL 35244 |
Activities
HEALTH CARE
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ULJJKLNZHW86 | 2024-07-24 | 1830 MONTCLAIR RD, STE A, IRONDALE, AL, 35210, 2645, USA | 1830 MONTCLAIR RD STE A, IRONDALE, AL, 35210, 2645, USA | |||||||||||||||||||||||||||||||||||||
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| Congressional District | 06 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2023-07-27 |
| Initial Registration Date | 2019-05-15 |
| Entity Start Date | 2014-10-02 |
| Fiscal Year End Close Date | Dec 31 |
Service Classifications
| NAICS Codes | 621420 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | WILLIAM WAINSCOTT |
| Address | 1830 MONTCLAIR RD STE A, IRONDALE, AL, 35210, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | WILLIAM WAINSCOTT |
| Address | 1830 MONTCLAIR RD STE A, IRONDALE, AL, 35210, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1841675865 | 2015-07-21 | 2020-03-10 | 1830 MONTCLAIR RD STE A, IRONDALE, AL, 352102645, US | 1830 MONTCLAIR RD STE A, IRONDALE, AL, 35210, US | |||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 205-618-9899 |
| Fax | 2056189706 |
| Phone | +1 205-775-0300 |
Authorized person
| Name | MR. WILLIAM CARL WAINSCOTT II |
| Role | CEO |
| Phone | 2056189899 |
Taxonomy
| Taxonomy Code | 101YA0400X - Addiction (Substance Use Disorder) Counselor |
| Is Primary | No |
| Taxonomy Code | 207QA0401X - Addiction Medicine (Family Medicine) Physician |
| Is Primary | Yes |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | MD.29132 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | MD.20646 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | MD.21506 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | No |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KOLBE CLINIC 401(K) PLAN | 2023 | 472078743 | 2024-05-21 | KOLBE CLINIC | 0 | |||||||||||||||||||||||||||||
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| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2024-05-21 |
| Name of individual signing | QIAN LIU |
| Name | Role | Address |
|---|---|---|
| LEGALZOOM.COM INC | Organizer | 101 N BRAND BLVD 10TH FLOORGLENDALE, CA 91203 |
| Name | Role |
|---|---|
| CORBETT, BRIAN C | Agent |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
