| Name: | WFR Behavioral ONE, LLC. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 21 Aug 2015 (9 years ago) |
| Entity Number: | 000-343-953 |
| Register Number: | 000343953 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 1025 MONTGOMERY HWY STE #214VESTAVIA, AL 35216 |
| Registered Office Street Address ZIP Code: | 35216 |
| Registered Office Mailing Address: | 1809 GLENDMERE DRIVEVESTAVIA, AL 35216 |
| Registered Office Mailing Address ZIP Code: | 35216 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1083086052 | 2015-10-29 | 2015-10-29 | 1025 MONTGOMERY HWY, SUITE #214, VESTAVIA, AL, 352162845, US | 1025 MONTGOMERY HWY, SUITE #214, VESTAVIA, AL, 352162845, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 205-233-1414 |
| Fax | 2058222732 |
Authorized person
| Name | MR. WILLIAM RICHARDSON |
| Role | OWNER/SCHOOL PSYCHOLOGIST |
| Phone | 2052331414 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| License Number | 1-15-19295 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 103TS0200X - School Psychologist |
| License Number | WXR-01058632 |
| State | AL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1588615918 |
| State | SC |
| Name | Role | Address |
|---|---|---|
| RICHARDSON, WILLIAM | Agent | 402 6TH AVENUE SWDECATUR, AL 35601 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
