| Name: | Behavioral Medicine LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 22 Jun 2015 (9 years ago) |
| Entity Number: | 000-338-600 |
| Register Number: | 000338600 |
| ZIP code: | 35209 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 100 OXMOORE ROAD SUITE 110BIRMINGHAM, AL 35209 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1326423781 | 2015-07-28 | 2018-05-24 | 8104 SEATON PL, MONTGOMERY, AL, 361167204, US | 8104 SEATON PL, MONTGOMERY, AL, 36116, US | |||||||||||||||||||||||
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| Phone | +1 334-272-3889 |
| Fax | 3342724089 |
Authorized person
| Name | MR. HERMAN W BEACHAM |
| Role | OWNER/PRESIDENT |
| Phone | 3342723889 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 179762 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| USCA INC | Agent | 101 N BRAND BLVD 11TH FLGLENDALE, CA 91203 |
| Name | Role | Address |
|---|---|---|
| LEGALZOOM.COM INC | Organizer | 101 N BRAND BLVD 10TH FLOORGLENDALE, CA 91203 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
