| Name: | South Shelby Wellness LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 02 Nov 2020 (4 years ago) (Companies founded in November 2020) |
| Entity Number: | 000-821-068 |
| Register Number: | 000821068 |
| ZIP code: | 35080 (Companies in Shelby, 35080) |
| County: | Shelby |
| Place of Formation: | Shelby County |
| Registered Office Street Address: | 265 NOTTINGHAM DRIVECALERA, AL 35080 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952984148 | 2021-05-04 | 2021-11-11 | 265 NOTTINGHAM DR, CALERA, AL, 350404984, US | 262 YEAGER PKWY STE F, PELHAM, AL, 351244884, US | |||||||||||||||||||
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| Phone | +1 205-617-1446 |
Authorized person
| Name | MELISSA WOODY |
| Role | LICENSED PROFESSIONAL COUNSELOR |
| Phone | 2056171446 |
Taxonomy
| Taxonomy Code | 101YP2500X - Professional Counselor |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 267463 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| WOODY, MELISSA A | Agent | 265 NOTTINGHAM DRIVECALERA, AL 35080 |
| Name | Role | Address |
|---|---|---|
| WOODY, MELISSA A | Organizer | 265 NOTTINGHAM DRIVECALERA, AL 35080 |
Date of last update: 16 Aug 2024
Sources: Alabama Secretary of State
