| Name: | Sunshine Behavioral Health Center, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 02 Nov 2017 (7 years ago) |
| Entity Number: | 000-407-716 |
| Register Number: | 000407716 |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Registered Office Street Address: | 18125 HIGHWAY 43MOUNT VERNON, AL 36560 |
| Registered Office Street Address ZIP Code: | 36560 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952813503 | 2017-11-03 | 2021-08-03 | 18125 HIGHWAY 43, MOUNT VERNON, AL, 365606415, US | 18125 HIGHWAY 43, MOUNT VERNON, AL, 365606415, US | |||||||||||||||||||||||
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| Phone | +1 251-545-6398 |
Authorized person
| Name | TRULY N. POLLARD |
| Role | EXECUTIVE DIRECTOR |
| Phone | 2514143599 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | 3669 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1639224744 |
| State | AL |
| Name | Role |
|---|---|
| SUNSHINE BEHAVIORAL HEALTH CENTER LL | Agent |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
