| Name: | Crossroads Family Clinic LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 26 May 2021 (3 years ago) |
| Entity Number: | 000-863-828 |
| Register Number: | 000863828 |
| County: | Lauderdale |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 52 Braden CoveRogersville, AL 35652 |
| Registered Office Street Address ZIP Code: | 35652 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538737010 | 2021-06-11 | 2021-06-11 | 75 COUNTY ROAD 576, ROGERSVILLE, AL, 35652, US | 75 COUNTY ROAD 576, ROGERSVILLE, AL, 35652, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 256-443-3171 |
Authorized person
| Name | HEATHER TENNELL GARRETT |
| Role | PROVIDER/OWNER |
| Phone | 2564433171 |
Taxonomy
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role |
|---|---|
| Garrett, Heather | Agent |
Date of last update: 16 Aug 2024
Sources: Alabama Secretary of State
