| Name: | Camellia Hospice of South Alabama, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 12 Jul 2016 (8 years ago) |
| Entity Number: | 000-372-821 |
| Register Number: | 000372821 |
| County: | Shelby |
| Place of Formation: | Mississippi |
| Principal Address: | 135 Mayfair RoadHattiesburg, MS 39402 |
| Registered Office Street Address: | 4000 EAGLE POINT CORPORATE DRIVEBIRMINGHAM, AL 35242 |
| Registered Office Street Address ZIP Code: | 35242 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053856591 | 2016-12-19 | 2022-07-01 | 6688 N CENTRAL EXPY STE 1300, DALLAS, TX, 752063950, US | 4782 WOODMERE BLVD STE C, MONTGOMERY, AL, 361063065, US | |||||||||||||||||||||
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| Phone | +1 214-239-6500 |
| Fax | 2142396581 |
| Phone | +1 334-289-1007 |
Authorized person
| Name | CRISSY BUCHANAN CARLISLE |
| Role | CHIEF FINANCIAL OFFICER |
| Phone | 2142396500 |
Taxonomy
| Taxonomy Code | 251G00000X - Community Based Hospice Care Agency |
| License Number | 15477 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| UNITED AGENT GROUP INC. | Agent |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
