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Mind Over Matter Behavioral Health LLC

Details

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) (Companies founded in August 2021)
Entity Number: 000-878-733
Register Number: 000878733
ZIP code: 36467 (Companies in Covington, 36467)
County: Covington
Place of Formation: Covington County
Registered Office Street Address: 131 E. COVINGTON AVE.OPP, AL 36467

National Provider Identifier

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

Contacts

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

Agent

Name Role Address
DAVID R ADAMS Agent 131 E. COVINGTON AVE.OPP, AL 36467

Organizer

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