| Name: | Alabama Care Network Mid-State |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Non-Profit Corporation |
| Status: | Exists |
| Date of registration: | 24 Jan 2019 (6 years ago) (Companies founded in January 2019) |
| Entity Number: | 000-540-992 |
| Register Number: | 000540992 |
| ZIP code: | 35203 (Companies in Jefferson, 35203) |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 417 20TH ST N STE 1100BIRMINGHAM, AL 35203 |
Activities
PROVIDE CARE COORDINATION SERVICES TO MEDICAID RECIPIENTS IN ALA
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104481837 | 2019-05-08 | 2023-04-24 | 417 20TH ST N STE 1100, BIRMINGHAM, AL, 352033216, US | 417 20TH ST N STE 1100, BIRMINGHAM, AL, 352033216, US | |||||||||||||||
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| Phone | +1 833-296-5245 |
| Fax | 2054499759 |
Authorized person
| Name | ANNA VELASCO |
| Role | SECRETARY |
| Phone | 8332965245 |
Taxonomy
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ROLLOW, BRAD | Agent | 417 20TH STREET NORTH SUITE 1100BIRMINGHAM, AL 35203 |
| Name | Role | Address |
|---|---|---|
| BACHELOR, BETH | Director | 1625 12TH AVE SBIRMINGHAM, AL 35205 |
| JENKINS, TODD | Director | 619 19TH ST SBIRMINGHAM, AL 35233 |
| MILLER, REBECCA | Director | 5607 TALLAPOOSA STREETNOTASULGA, AL 36866 |
| HAUETER, AMELIA | Director | 5720 1ST AVE SBIRMINGHAM, AL 35212 |
| CRAIG, RICHARD | Director | 940 MONTCLAIR RD STE 200BIRMINGHAM, AL 35213 |
| LILLY, DON | Director | 500 22ND ST SBIRMINGHAM, AL 35233 |
| MASSEY, BRIAN | Director | 2800 UNIVERSITY BLVDBIRMINGHAM, AL 35233 |
| BROWN, KHALILAH | Director | 1400 6TH AVE SBIRMINGHAM, AL 35233 |
| RECORD, ROBERT | Director | 5720 1ST AVE SBIRMINGHAM, AL 35212 |
| HEDRICK, BEN | Director | 1110 DEARING DOWNS DRHELENA, AL 35080 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
