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North Alabama Family Psychiatry and Counseling, LLC

Details

Name: North Alabama Family Psychiatry and Counseling, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 13 Oct 2015 (9 years ago) (Companies founded in October 2015)
Entity Number: 000-347-183
Register Number: 000347183
ZIP code: 35209 (Companies in Jefferson, 35209)
County: Jefferson
Place of Formation: Jefferson County
Registered Office Street Address: 100 OXMOORE ROAD SUITE 110BIRMINGHAM, AL 35209

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1003368671 2016-10-31 2016-10-31 9238 MADISON BLVD, SUITE 750, MADISON, AL, 357589100, US 9238 MADISON BLVD, SUITE 750, MADISON, AL, 357589100, US

Contacts

Phone +1 256-727-8880
Fax 8889517515

Authorized person

Name MR. BRUCE Y PETTWAY
Role PRESIDENT
Phone 2567248880

Taxonomy

Taxonomy Code 261QM0850X - Adult Mental Health Clinic/Center
Is Primary Yes
Taxonomy Code 261QM0855X - Adolescent and Children Mental Health Clinic/Center
Is Primary No

Agent

Name Role Address
USCA INC Agent 101 N BRAND BLVD 11TH FLGLENDALE, CA 91203

Organizer

Name Role Address
MOSELEY, CHEYENNE Organizer 9900 SPECTRUM DRIVEAUSTIN, TX 78717

Date of last update: 03 Aug 2024

Sources: Alabama Secretary of State