| Name: | Southeast Alabama HomeCare, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 30 Oct 2008 (16 years ago) (Companies founded in October 2008) |
| Entity Number: | 000-426-748 |
| Register Number: | 000426748 |
| Historical Names: |
Southeast Alabama Medical Center HomeCare, LLC
|
| ZIP code: | 36104 (Companies in Montgomery, 36104) |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Registered Office Street Address: | 2 N JACKSON STREET, SUITE 605MONTGOMERY, AL 36104 |
Activities
HEALTH CARE SERVICES
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| E4BSVNLAA3C4 | 2025-01-04 | 1435 ROSS CLARK CIR STE 2, DOTHAN, AL, 36301, 4746, USA | PO BOX 51266, LAFAYETTE, LA, 70505, 1266, USA | |||||||||||||||||||||||||||||||||||||||||||||||||||
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| Congressional District | 02 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2024-01-10 |
| Initial Registration Date | 2024-01-05 |
| Entity Start Date | 2008-12-31 |
| 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 RD SOUTH, LAFAYETTE, LA, 70508, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | MIA GUIDRY |
| Role | PARALEGAL |
| Address | 901 HUGH WALLIS RD SOUTH, LAFAYETTE, LA, 70508, USA |
| Title | ALTERNATE POC |
| Name | DANA NELSON |
| Role | PARALEGAL |
| Address | 901 HUGH WALLIS RD SOUTH, LAFAYETTE, LA, 70508, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902041247 | 2008-12-15 | 2020-12-01 | PO BOX 51266, LAFAYETTE, LA, 705051266, US | 1435 ROSS CLARK CIR STE 2, DOTHAN, AL, 363014746, US | |||||||||||||||||||||||||
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| Phone | +1 337-233-1307 |
| Fax | 3372335764 |
| Phone | +1 334-794-0591 |
| Fax | 3347936073 |
Authorized person
| Name | MR. NICHOLAS GACHASSIN III |
| Role | EXECUTIVE VICE PRESIDENT |
| Phone | 3372331307 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 113803 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| C T CORPORATION SYSTEM | Agent | 2 NORHT JACKSON STREET SUITE 605MONTGOMERY, AL 36104 |
| Name | Role |
|---|---|
| SOUTHEAST ALABAMA MEDICAL CENTER | Member |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2008-11-26 | Name Change | Southeast Alabama Medical Center HomeCare, LLC | Southeast Alabama HomeCare, LLC |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
