| Name: | J. Trice Psychiatric Services, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 24 Aug 2017 (7 years ago) |
| Entity Number: | 000-401-972 |
| Register Number: | 000401972 |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Registered Office Street Address: | 273 AZALEA ROAD BLDG 1-206MOBILE, AL 36609 |
| Registered Office Street Address ZIP Code: | 36609 |
| Authorized Capital: | 1,000 @ $1/PV |
Activities
PROVIDE PROFESSIONAL PSYCHIATRIC SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962913418 | 2017-10-23 | 2017-10-23 | PO BOX 9128, MOBILE, AL, 366910128, US | 3929 AIRPORT BLVD STE 1-206, MOBILE, AL, 366092233, US | |||||||||||||||||||||||||
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| Phone | +1 251-721-9649 |
Authorized person
| Name | AMBER CHAVIS |
| Role | OFFICE MANAGER |
| Phone | 2514215255 |
Taxonomy
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| License Number | 1-053065 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 364SP0810X - Child & Family Psychiatric/Mental Health Clinical Nurse Specialist |
| License Number | 1-053065 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| TRICE, JULIE | Agent | 273 AZALEA ROAD BLDG 1-206MOBILE, AL 36609 |
| Name | Role | Address |
|---|---|---|
| TRICE, JULIE | Director | 273 AZALEA ROAD BLDG 1-206MOBILE, AL 36609 |
| Name | Role | Address |
|---|---|---|
| TRICE, JULIE | Incorporator | 273 AZALEA ROAD BLDG 1-206MOBILE, AL 36609 |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
