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Restoration Health of South Alabama, Inc.

Details

Name: Restoration Health of South Alabama, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Exists
Date of registration: 31 May 2017 (7 years ago)
Entity Number: 000-392-905
Register Number: 000392905
County: Baldwin
Place of Formation: Baldwin County
Registered Office Street Address: 27961 US HWY 98 STE 10DAPHNE, AL 36526
Registered Office Street Address ZIP Code: 36526
Authorized Capital: 10,000 @ $1.00 PV

Activities TRANSACTION OF ALL LAWFUL BUSINESS

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1609391853 2017-08-09 2017-08-09 3280 DAUPHIN ST BLDG A, MOBILE, AL, 366064060, US 30762 STATE HIGHWAY 181, SPANISH FORT, AL, 365275672, US

Contacts
Phone +1 251-450-3700
Fax 2515453010
Phone +1 251-626-0732
Fax 2512721983

Authorized person
Name DR. JONATHAN CLAY RAINER
Role PRESIDENT
Phone 2516260732

Taxonomy
Taxonomy Code 208100000X - Physical Medicine & Rehabilitation Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
RESTORATION HEALTH OF SOUTH ALABAMA, INC. 401(K) PROFIT SHARING PLAN 2023 821803192 2024-07-17 RESTORATION HEALTH OF SOUTH ALABAMA, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 2516260732
Plan sponsor’s address 30762 STATE HIGHWAY 181, SPANISH FORT, AL, 36527

Signature of
Role Plan administrator
Date 2024-07-17
Name of individual signing JERRY GOLDEN
Role Employer/plan sponsor
Date 2024-07-17
Name of individual signing JERRY GOLDEN
RESTORATION HEALTH OF SOUTH ALABAMA, INC. 401(K) PROFIT SHARING PLAN 2022 821803192 2023-05-24 RESTORATION HEALTH OF SOUTH ALABAMA, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 2516260732
Plan sponsor’s address 30762 STATE HIGHWAY 181, SPANISH FORT, AL, 36527

Signature of
Role Plan administrator
Date 2023-05-24
Name of individual signing JERRY GOLDEN
Role Employer/plan sponsor
Date 2023-05-24
Name of individual signing JERRY GOLDEN
RESTORATION HEALTH OF SOUTH ALABAMA, INC. 401(K) PROFIT SHARING PLAN 2021 821803192 2022-05-25 RESTORATION HEALTH OF SOUTH ALABAMA, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 2516260732
Plan sponsor’s address 30762 STATE HIGHWAY 181, SPANISH FORT, AL, 36527

Signature of
Role Plan administrator
Date 2022-05-25
Name of individual signing JERRY GOLDEN
Role Employer/plan sponsor
Date 2022-05-25
Name of individual signing JERRY GOLDEN
RESTORATION HEALTH OF SOUTH ALABAMA, INC. 401(K) PROFIT SHARING PLAN 2020 821803192 2021-06-09 RESTORATION HEALTH OF SOUTH ALABAMA, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 2516260732
Plan sponsor’s address 30762 STATE HIGHWAY 181, SPANISH FORT, AL, 36527

Signature of
Role Plan administrator
Date 2021-06-09
Name of individual signing JERRY GOLDEN
Role Employer/plan sponsor
Date 2021-06-09
Name of individual signing JERRY GOLDEN
RESTORATION HEALTH OF SOUTH ALABAMA, INC. 401(K) PROFIT SHARING PLAN 2019 821803192 2020-04-21 RESTORATION HEALTH OF SOUTH ALABAMA, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 2516260732
Plan sponsor’s address 30762 STATE HIGHWAY 181, SPANISH FORT, AL, 36527

Signature of
Role Plan administrator
Date 2020-04-21
Name of individual signing JERRY GOLDEN
Role Employer/plan sponsor
Date 2020-04-21
Name of individual signing JERRY GOLDEN

Agent

Name Role
RAINER, J C Agent

Director

Name Role Address
RAINER, J CLAY Director 27961 US HWY 98 STE 10DAPHNE, AL 36526

Incorporator

Name Role Address
O'DOWD, J M JR Incorporator PO BOX 123MOBILE, AL 36601

Related by officers

O'DOWD, J M JR

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Related by address

No related companies by address

Date of last update: 13 Aug 2024

Sources: Alabama Secretary of State

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