| Name: | IVY CREEK HEALTHCARE, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 15 Jul 2013 (11 years ago) |
| Entity Number: | 000-352-525 |
| Register Number: | 000352525 |
| County: | Tallapoosa |
| Place of Formation: | Florida |
| Principal Address: | 16020 SW 80TH AVEMIAMI, FL 33157 |
| Registered Office Street Address: | 201 MARIARDEN RDDADEVILLE, AL 36853 |
| Registered Office Street Address ZIP Code: | 36853 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851823108 | 2017-03-28 | 2017-03-28 | 1210 7TH ST S, CLANTON, AL, 350453724, US | 1210 7TH ST S, CLANTON, AL, 350453724, US | |||||||||||||||||
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| Phone | +1 205-280-0620 |
Authorized person
| Name | SAVANNAH JANE MOON |
| Role | NURSE PRACTITIONER |
| Phone | 2055853315 |
Taxonomy
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| License Number | 1-140246 |
| State | AL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| IVY CREEK HEALTHCARE 401(K) PLAN | 2023 | 463633786 | 2024-10-09 | IVY CREEK HEALTHCARE, LLC | 356 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-10-09 |
| Name of individual signing | MICHAEL BRUCE |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| BRUCE, MICHAEL | Agent | 42 MALCOLM AVENUE SWRAINSVILLE, AL 35986 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
