| Name: | Excel Rehabilitation, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 31 Jan 2006 (19 years ago) (Companies founded in January 2006) |
| Entity Number: | 000-474-241 |
| Register Number: | 000474241 |
| ZIP code: | 36117 (Companies in Montgomery, 36117) |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Principal Address: | MONTGOMERY, AL |
| Registered Office Street Address: | 340 MENDEL PKWY WESTMONTGOMERY, AL 36117 |
| Registered Office Mailing Address: | 399 MOUNTAIN RIDGE ROADMILLBROOK, AL 36054 |
Activities
OCCUPATIONAL & PHYSICAL THERAPY SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184714719 | 2006-10-13 | 2012-12-28 | 399 MOUNTAIN RIDGE RD, MILLBROOK, AL, 360542128, US | 2125 E SOUTH BLVD, MONTGOMERY, AL, 361162409, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 334-285-7101 |
| Phone | +1 334-532-0220 |
| Fax | 3345320221 |
Authorized person
| Name | MRS. RUSTY G BECKER |
| Role | CEO |
| Phone | 3345320220 |
Taxonomy
| Taxonomy Code | 225XP0200X - Pediatric Occupational Therapist |
| License Number | 2334 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529926860 |
| State | AL |
| Issuer | BCBS PRO NUMBER |
| Number | 51524863 |
| State | AL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EXCEL REHABILITATION LLC 401K PLAN | 2023 | 830445931 | 2024-07-15 | EXCEL REHABILITATION LLC | 14 | |||||||||||||||||||||
|
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| Role | Plan administrator |
| Date | 2024-07-15 |
| Name of individual signing | RUSTY BECKER |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2021-01-01 |
| Business code | 621340 |
| Sponsor’s telephone number | 3345320220 |
| Plan sponsor’s address | 340 MENDEL PKWY W, MONTGOMERY, AL, 36117 |
Signature of
| Role | Plan administrator |
| Date | 2023-06-15 |
| Name of individual signing | ERIC BECKER |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2021-01-01 |
| Business code | 621340 |
| Sponsor’s telephone number | 3345320220 |
| Plan sponsor’s address | 340 MENDEL PKWY W, MONTGOMERY, AL, 36117 |
Signature of
| Role | Plan administrator |
| Date | 2022-10-06 |
| Name of individual signing | ERIC BECKER |
| Name | Role |
|---|---|
| BECKER, RUSTY G | Agent |
| Name | Role |
|---|---|
| BECKER, RUSTY | Member |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
