| Name: | Wiregrass Behavioral Group, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 08 Mar 2018 (7 years ago) |
| Entity Number: | 000-511-845 |
| Register Number: | 000511845 |
| County: | Houston |
| Place of Formation: | Houston County |
| Registered Office Street Address: | 105 RICHBERRY DRIVEDOTHAN, AL 36301 |
| Registered Office Street Address ZIP Code: | 36301 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821609389 | 2020-08-10 | 2020-08-13 | 256 HONEYSUCKLE RD STE 12, DOTHAN, AL, 363051168, US | 256 HONEYSUCKLE RD STE 12, DOTHAN, AL, 363051168, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 334-792-6736 |
| Fax | 3347926737 |
Authorized person
| Name | MISS PHILLIP JOHNSON |
| Role | PRESIDENT |
| Phone | 3347926736 |
Taxonomy
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| JOHNSON, PHILLIP | Agent | 105 RICHBERRY DRIVEDOTHAN, AL 36301 |
| Name | Role | Address |
|---|---|---|
| JOHNSON, PHILLIP | Organizer | 105 RICHBERRY DRIVEDOTHAN, AL 36301 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
