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GRACE COUNSELING CENTER, LLC

Details

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) (Companies founded in July 2017)
Entity Number: 000-395-762
Register Number: 000395762
ZIP code: 36426 (Companies in Escambia, 36426)
County: Escambia
Place of Formation: Escambia County
Registered Office Street Address: 1305 MCMILLAN AVEBREWTON, AL 36426

National Provider Identifier

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

Contacts

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

Agent

Name Role
SMITH, TOMMY W DR Agent

Date of last update: 13 Aug 2024

Sources: Alabama Secretary of State