| Name: | Optimal Mental Health Virtual Clinic, PLLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 30 Mar 2021 (4 years ago) |
| Entity Number: | 000-843-982 |
| Register Number: | 000843982 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Mailing Address: | 8528 CREEKVIEW TRACETRUSSVILLE, AL 35173 |
| Registered Office Mailing Address ZIP Code: | 35173 |
| Registered Office Street Address: | 1430 GADSDEN HWY STE 116-618BIRMINGHAM, AL 35235 |
| Registered Office Street Address ZIP Code: | 35235 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558034892 | 2021-07-30 | 2021-07-30 | 1430 GADSDEN HWY STE 116-618, BIRMINGHAM, AL, 352353103, US | 1430 GADSDEN HWY STE 116-618, BIRMINGHAM, AL, 352353103, US | |||||||||||||
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| Phone | +1 205-775-0080 |
Authorized person
| Name | DR. SUMMYJI GROOM |
| Role | CEO |
| Phone | 2057750080 |
Taxonomy
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role |
|---|---|
| GROOM, SUMMYJI | Agent |
Date of last update: 16 Aug 2024
Sources: Alabama Secretary of State
