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David Anakwenze, MD Psychiatric Outreach, LLC

Details

Name: David Anakwenze, MD Psychiatric Outreach, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 15 Jun 2006 (18 years ago) (Companies founded in June 2006)
Entity Number: 000-480-232
Register Number: 000480232
ZIP code: 35630 (Companies in Lauderdale, 35630)
County: Lauderdale
Place of Formation: Lauderdale County
Principal Address: FLORENCE, AL
Registered Office Street Address: 250 NORTH SEQUOIA BLVDFLORENCE, AL 35630

Activities PSYCHIATRIC MEDICAL SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1487722302 2006-11-30 2024-05-09 2809 W MALL DR, FLORENCE, AL, 356301563, US 2809 W MALL DR, FLORENCE, AL, 356301563, US

Contacts

Phone +1 256-767-4805
Fax 2567674954

Authorized person

Name DAVID ANAKWENZE
Role MEDICAL DOCTOR
Phone 2567674805

Taxonomy

Taxonomy Code 2084P0800X - Psychiatry Physician
License Number AL23908
State AL
Is Primary Yes

Agent

Name Role
ANAKWENZE, DAVID Agent

Member

Name Role
ANAKWENZE, DAVID Member

Date of last update: 14 Aug 2024

Sources: Alabama Secretary of State