| Name: | Gibson Therapy Services, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 21 Mar 2016 (9 years ago) |
| Entity Number: | 000-356-940 |
| Register Number: | 000356940 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Registered Office Street Address: | 420 28TH AVENUE, SUITE 100TUSCALOOSA, AL 35401 |
| Registered Office Street Address ZIP Code: | 35401 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639727183 | 2019-08-28 | 2024-02-26 | 2720 7TH ST, TUSCALOOSA, AL, 354011806, US | 2720 7TH ST, TUSCALOOSA, AL, 354011806, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 205-210-8099 |
| Fax | 2052482254 |
Authorized person
| Name | MRS. CHRISTIE W GIBSON |
| Role | OWNER |
| Phone | 2052108099 |
Taxonomy
| Taxonomy Code | 106H00000X - Marriage & Family Therapist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 511-74803 |
| State | AL |
| Issuer | AMERICAN BEHAVIORAL |
| Number | 1124451638 |
| State | AL |
| Name | Role |
|---|---|
| GIBSON, CHRISTIE W | Agent |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
