| Name: | Faith and Grace Hospice, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Non-Profit Corporation |
| Status: | Dissolved |
| Date of registration: | 14 Nov 2005 (19 years ago) |
| Date of dissolution: | 29 Apr 2011 |
| Entity Number: | 000-562-737 |
| Register Number: | 000562737 |
| County: | Jefferson |
| Place of Formation: | Montgomery County |
| Principal Address: | BIRMINGHAM, AL |
| Registered Office Street Address: | 347 VESCLUB DRIVEBIRMINGHAM, AL 35216 |
| Registered Office Street Address ZIP Code: | 35216 |
Activities
PROVIDE CHARITABLE HOSPICE SERVICE TO TERMINALLY ILL PATIENTS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245377464 | 2007-01-30 | 2020-08-22 | 540 CLAY ST, MONTGOMERY, AL, 361043367, US | 540 CLAY ST, MONTGOMERY, AL, 361043367, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 334-834-9800 |
| Fax | 3348349808 |
Authorized person
| Name | MRS. MARGARET E. THOMPSON |
| Role | DIRECTOR |
| Phone | 3348349800 |
Taxonomy
| Taxonomy Code | 251G00000X - Community Based Hospice Care Agency |
| License Number | 016629 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | PIC1648E |
| State | AL |
| Issuer | BCBS OF AL PROVIDER # |
| Number | 012720 |
| State | AL |
| Name | Role |
|---|---|
| CARLSON, WILLIAM T JR | Agent |
| Name | Role |
|---|---|
| WELLS, MARGARET | Incorporator |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
