Name: | WFR Behavioral ONE, LLC. |
Jurisdiction: | Alabama |
Legal type: | Domestic Limited Liability Company |
Status: | Exists |
Date of registration: | 21 Aug 2015 (9 years ago) (Companies founded in August 2015) |
Entity Number: | 000-343-953 |
Register Number: | 000343953 |
ZIP code: | 35216 (Companies in Jefferson, 35216) |
County: | Jefferson |
Place of Formation: | Jefferson County |
Registered Office Street Address: | 1025 MONTGOMERY HWY STE #214VESTAVIA, AL 35216 |
Registered Office Mailing Address: | 1809 GLENDMERE DRIVEVESTAVIA, AL 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 | |||||||||||||||||||||||||||||||||
|
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