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
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 | |||||||||||||||||||||||||||||||
|
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 |
Name | Role |
---|---|
TIESZEN, STUART C | Agent |
Name | Role |
---|---|
TIESZEN, STUART C | Member |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State