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Brookwood Psychiatric Associates, L.L.C.

Details

Name: Brookwood Psychiatric Associates, L.L.C.
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Dissolved
Date of registration: 29 Dec 1998 (26 years ago) (Companies founded in December 1998)
Date of dissolution: 05 Dec 2022
Entity Number: 000-662-436
Register Number: 000662436
ZIP code: 35209 (Companies in Jefferson, 35209)
County: Jefferson
Place of Formation: Jefferson County
Registered Office Street Address: 2018 BROOKWOOD MEDICAL CENTER DRHOMEWOOD, AL 35209

Activities PROVIDE PSYCHIATRIC SERVICES TO THE PUBLIC

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1972774362 2008-03-13 2008-03-13 2018 BROOKWOOD MEDICAL CTR DR, POB SUITE 311, BIRMINGHAM, AL, 352096898, US 2018 BROOKWOOD MEDICAL CTR DR, POB SUITE 311, BIRMINGHAM, AL, 352096898, US

Contacts

Phone +1 205-329-7805
Fax 2053297806

Authorized person

Name DR. STUART C TIESZEN
Role DOCTOR
Phone 2053297805

Taxonomy

Taxonomy Code 2084P0800X - Psychiatry Physician
License Number 0012918
State AL
Is Primary Yes

Other Provider Identifiers

Issuer US DEPTPARTMENT OF LABOR
Number 1168112100
State AL
Issuer UPIN
Number C75916
State AL

Agent

Name Role
TIESZEN, STUART C Agent

Member

Name Role
TIESZEN, STUART C Member

Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State