| Name: | Phoenix Community Support Services LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 20 Aug 2020 (4 years ago) |
| Entity Number: | 000-644-211 |
| Register Number: | 000644211 |
| County: | Baldwin |
| Place of Formation: | Baldwin County |
| Registered Office Street Address: | 3151 Boulevard De Sevilla Blvd,Foley, AL 36535 |
| Registered Office Street Address ZIP Code: | 36535 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518563329 | 2020-12-07 | 2020-12-07 | 4111 AVENUE L, BIRMINGHAM, AL, 352081807, US | 4111 AVENUE L, BIRMINGHAM, AL, 352081807, US | |||||||||||||||||
|
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| Phone | +1 803-849-2925 |
Authorized person
| Name | LASHUNDA SMITH POPE |
| Role | OWNER |
| Phone | 8038492925 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
| Name | Role |
|---|---|
| Roberts, Kimberly | Agent |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
