| Name: | Adoration Hospice Care Alabama, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 15 Mar 2021 (4 years ago) |
| Entity Number: | 000-842-676 |
| Register Number: | 000842676 |
| County: | Montgomery |
| Place of Formation: | Delaware |
| Principal Address: | 805 N WHITTINGTON PARKWAY SUITE 400LOUISVILLE, KY 40222 |
| Registered Office Street Address: | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
| Registered Office Street Address ZIP Code: | 36104 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437220456 | 2006-11-13 | 2024-04-03 | 1000 SOUTHLAKE PARK STE 100, BIRMINGHAM, AL, 352445700, US | 1631 HAMRIC DR E, OXFORD, AL, 362032035, US | |||||||||||||||||||||||||||||||
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| Phone | +1 205-682-9996 |
| Fax | 2056829994 |
Authorized person
| Name | ANGIE MATTINGLY |
| Role | MANAGER PROVIDER ENROLLMENT |
| Phone | 5023813579 |
Taxonomy
| Taxonomy Code | 251G00000X - Community Based Hospice Care Agency |
| License Number | 11683 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | PIC1629E |
| State | AL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 012537 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY | Agent | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
Date of last update: 16 Aug 2024
Sources: Alabama Secretary of State
