| Name: | Wiregrass Behavioral Systems, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 06 Feb 2015 (10 years ago) (Companies founded in February 2015) |
| Entity Number: | 000-328-092 |
| Register Number: | 000328092 |
| ZIP code: | 36305 (Companies in Houston, 36305) |
| County: | Houston |
| Place of Formation: | Henry County |
| Registered Office Street Address: | 511 PRESTWICK DRIVEDOTHAN, AL 36305 |
| Authorized Capital: | 1,000 @ $1.00PV |
Activities
OUTPATIENT BEHAVORIAL MEDICINE
HEALTH CARE & CONSULTATIVE SERVIC
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568840460 | 2015-05-12 | 2015-05-12 | 1358 STATE HIGHWAY 134 E, HEADLAND, AL, 363458517, US | 6501 US HIGHWAY 431 N, HEADLAND, AL, 363455657, US | |||||||||||||||||
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| Phone | +1 334-695-2253 |
Authorized person
| Name | DR. BASCOM KYLE BRADSHAW |
| Role | DIRECTOR |
| Phone | 2104543703 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | DO.1388 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BRADSHAW, BASCOM K | Agent | 1358 STATE HIGHWAY 134 EASTHEADLAND, AL 36345 |
| Name | Role | Address |
|---|---|---|
| BRADSHAW, BASCOM K | Director | 1358 STATE HIGHWAY 134 EASTHEADLAND, AL 36345 |
| Name | Role | Address |
|---|---|---|
| HINESLEY, WILLIAM W | Incorporator | 291 NORTH OATES STEETDOTHAN, AL 36302 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
