| Name: | Montgomery Children's Specialty Center, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 13 Sep 2010 (14 years ago) (Companies founded in September 2010) |
| Entity Number: | 000-620-390 |
| Register Number: | 000620390 |
| ZIP code: | 36104 (Companies in Montgomery, 36104) |
| County: | Montgomery |
| Place of Formation: | Missouri |
| Principal Address: | 7611 STATE LINE RD STE 301KANSAS CITY, MO 64114 |
| Registered Office Street Address: | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
Activities
OPERATOR OF CHILDREN'S SPECIALTY CENTER
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225347495 | 2010-10-05 | 2010-10-19 | 2853 FORBES, MONTGOMERY, AL, 361101307, US | 2853 FORBES, MONTGOMERY, AL, 361101307, US | |||||||||||||||||||||||
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| Phone | +1 334-262-6421 |
Authorized person
| Name | JOSEPH C TUTERA |
| Role | MANAGER |
| Phone | 8164440900 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 123323 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1225347495 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY INC | Agent | 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808 |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
