| Name: | GRACE COUNSELING CENTER, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 06 Jul 2017 (7 years ago) |
| Entity Number: | 000-395-762 |
| Register Number: | 000395762 |
| County: | Escambia |
| Place of Formation: | Escambia County |
| Registered Office Street Address: | 1305 MCMILLAN AVEBREWTON, AL 36426 |
| Registered Office Street Address ZIP Code: | 36426 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588177570 | 2017-11-13 | 2017-11-13 | 7120 AIRPORT BLVD, MOBILE, AL, 366084502, US | 7120 AIRPORT BLVD, MOBILE, AL, 36608, US | |||||||||||||
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| Phone | +1 251-345-3303 |
Authorized person
| Name | JOHNATHAN SHANE BLACK |
| Role | COUNSELOR |
| Phone | 2516480835 |
Taxonomy
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| Is Primary | Yes |
| Name | Role |
|---|---|
| SMITH, TOMMY W DR | Agent |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
