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Clinic 5 Addiction Recovery, LLC

Details

Name: Clinic 5 Addiction Recovery, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 25 Jan 2017 (8 years ago) (Companies founded in January 2017)
Entity Number: 000-381-905
Register Number: 000381905
ZIP code: 35906 (Companies in Etowah, 35906)
County: Etowah
Place of Formation: Etowah County
Registered Office Street Address: 1 INDEPENDENT DRIVERAINBOW CITY, AL 35906

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1639808934 2022-06-10 2022-06-10 1 INDEPENDENT DR, RAINBOW CITY, AL, 359063249, US 1 INDEPENDENT DR, RAINBOW CITY, AL, 359063249, US

Contacts

Phone +1 256-312-2101
Fax 2569522769
Phone +1 256-952-2709

Authorized person

Name MRS. JENNIFER THRASHER
Role CEO
Phone 2563122101

Taxonomy

Taxonomy Code 2083A0300X - Addiction Medicine (Preventive Medicine) Physician
Is Primary Yes
Taxonomy Code 261QM2500X - Medical Specialty Clinic/Center
Is Primary No
Taxonomy Code 261QR0800X - Recovery Care Clinic/Center
Is Primary No
Taxonomy Code 3245S0500X - Children's Substance Abuse Rehabilitation Facility
Is Primary No

Agent

Name Role Address
THRASHER, JENNY Agent 1186 LAKE FOREST DRIVE NSOUTHSIDE, AL 35907

Organizer

Name Role Address
THRASHER, JENNY Organizer 1186 LAKE FOREST DRIVE NSOUTHSIDE, AL 35907
THRASHER, TRENT Organizer 1186 LAKE FOREST DRIVE NSOUTHSIDE, AL 35907

Date of last update: 13 Aug 2024

Sources: Alabama Secretary of State