| Name: | The Centre |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Non-Profit Corporation |
| Status: | Exists |
| Date of registration: | 07 Apr 2008 (17 years ago) |
| Entity Number: | 000-567-645 |
| Register Number: | 000567645 |
| County: | Baldwin |
| Place of Formation: | Baldwin County |
| Registered Office Street Address: | 1256 FRANCES STDAPHNE, AL 36526 |
| Registered Office Street Address ZIP Code: | 36526 |
| Principal Address: | DAPHNE, AL |
Activities
CLINICAL/FAITH-BASED SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104073592 | 2008-08-27 | 2008-09-16 | 1290 MAIN ST STE E, DAPHNE, AL, 365268624, US | 1290 MAIN ST STE E, DAPHNE, AL, 365268624, US | |||||||||||||||||||||||||||||||
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| Phone | +1 251-625-0118 |
| Fax | 2516250116 |
Authorized person
| Name | MR. ROBERT EDWIN COLCLOUGH |
| Role | DIRECTOR |
| Phone | 2516250118 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | LPC 111 AL |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS |
| Number | 515 92982 |
| State | AL |
| Issuer | BLUE CROSS ROBERT COLCLOUGH |
| Number | 515 92986 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| BORDENKIRCHER, SUSAN | Incorporator | No data |
| BORDENKIRCHER, GREGORY A | Incorporator | No data |
| COLCLOUGH, ROBERT | Incorporator | No data |
| COLCLOUGH, LINDA | Incorporator | 2110 MAIN STREETDAPHNE, AL 36526 |
| Name | Role |
|---|---|
| BORDENKIRCHER, GREGORY A | Agent |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
