| Name: | HGA HomeCare, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 18 Oct 2007 (17 years ago) (Companies founded in October 2007) |
| Entity Number: | 000-411-303 |
| Register Number: | 000411303 |
| ZIP code: | 36104 (Companies in Montgomery, 36104) |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Principal Address: | MONTGOMERY, AL |
| Registered Office Street Address: | 2 NORTH JACKSON STREET, SUITE 605MONTGOMERY, AL 36104 |
Activities
HEALTH CARE SERVICES
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| J9T4PVRKX1C7 | 2024-07-10 | 500 BOULEVARD SOUTH SW STE 203, HUNTSVILLE, AL, 35802, 2103, USA | P O BOX 51266, LAFAYETTE, LA, 70505, 1266, USA | |||||||||||||||||||||||||||||||||||||||||||||||||||
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| Congressional District | 05 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2023-07-21 |
| Initial Registration Date | 2023-07-05 |
| Entity Start Date | 2007-11-01 |
| Fiscal Year End Close Date | Dec 31 |
Service Classifications
| NAICS Codes | 621610 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | TAMMY LANTHIER |
| Role | REVENUE CYCLE |
| Address | 901 HUGH WALLIS ROAD SOUTH, LAFAYETTE, LA, 70508, 2511, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | DANA NELSON |
| Role | LICENSURE PARALEGAL |
| Address | 901 HUGH WALLIS ROAD SOUTH, LAFAYETTE, LA, 70508, 2511, USA |
| Past Performance | |
|---|---|
| Title | ALTERNATE POC |
| Name | MIA GUIDRY |
| Role | LICENSURE PARALEGAL |
| Address | 901 HUGH WALLIS ROAD SOUTH, LAFAYETTE, LA, 70508, USA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1144409004 | 2007-10-29 | 2020-11-24 | PO BOX 51266, LAFAYETTE, LA, 705051266, US | 2708 HIGHWAY 31 S, SUITE B, DECATUR, AL, 356031508, US | |||||||||||||||||||||||||||||||
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| Phone | +1 337-233-1307 |
| Fax | 3372335764 |
| Phone | +1 256-350-4182 |
| Fax | 2563095908 |
Authorized person
| Name | MR. NICHOLAS GACHASSIN III |
| Role | TREASURER |
| Phone | 3372331307 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 104840 |
| State | AL |
| Issuer | MEDICAID |
| Number | HEL7027A |
| State | AL |
| Name | Role | Address |
|---|---|---|
| C T CORPORATION SYSTEM | Agent | 2 NORHT JACKSON STREET SUITE 605MONTGOMERY, AL 36104 |
| Name | Role |
|---|---|
| HEALTHGROUP OF ALABAMA LLC | Member |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
