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Generations of Red Bay, LLC

Details

Name: Generations of Red Bay, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 08 Dec 2009 (15 years ago)
Entity Number: 000-440-892
Register Number: 000440892
County: Montgomery
Place of Formation: Montgomery County
Principal Address: MONTGOMERY, AL
Registered Office Street Address: 2 NORTH JACKSON STREET SUITE 605MONTGOMERY, AL 36104
Registered Office Street Address ZIP Code: 36104

Activities SKILLED NURSING FACILITY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1619964970 2005-10-03 2010-08-05 106 10TH AVE NW, RED BAY, AL, 355823800, US 106 10TH AVE NW, RED BAY, AL, 355823800, US

Contacts

Phone +1 256-356-4982
Fax 2563568400

Authorized person

Name MR. JOHN ERIC MELTON
Role MEMBER/CFO
Phone 2055458444

Taxonomy

Taxonomy Code 314000000X - Skilled Nursing Facility
License Number 10989
State AL
Is Primary Yes

Other Provider Identifiers

Issuer STATE LICENSE NUMBER
Number 10989
State AL
Issuer MEDICAID
Number 4754080S
State AL

Agent

Name Role
NATIONAL REGISTERED AGENTS INC Agent

Member

Name Role
FULLER, AUNDREA D Member
MELTON, J ERIC Member

Date of last update: 13 Aug 2024

Sources: Alabama Secretary of State