| Name: | Mind Over Matter Behavioral Health LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 17 Aug 2021 (3 years ago) |
| Entity Number: | 000-878-733 |
| Register Number: | 000878733 |
| County: | Covington |
| Place of Formation: | Covington County |
| Registered Office Street Address: | 131 E. COVINGTON AVE.OPP, AL 36467 |
| Registered Office Street Address ZIP Code: | 36467 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487321089 | 2021-08-23 | 2021-08-23 | 131 E COVINGTON AVE, OPP, AL, 364672122, US | 131 E COVINGTON AVE, OPP, AL, 364672122, US | |||||||||||||||||||||||
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| Phone | +1 334-804-6937 |
| Fax | 7162653348 |
Authorized person
| Name | DAVID RUSSELL ADAMS |
| Role | OWNER/CEO |
| Phone | 3348046937 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| DAVID R ADAMS | Agent | 131 E. COVINGTON AVE.OPP, AL 36467 |
| Name | Role | Address |
|---|---|---|
| DAVID R ADAMS | Organizer | 131 E. COVINGTON AVE.OPP, AL 36467 |
Date of last update: 16 Aug 2024
Sources: Alabama Secretary of State
