| Name: | Mid-South Home Health, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 12 Jan 1984 (41 years ago) |
| Entity Number: | 000-884-976 |
| Register Number: | 000884976 |
| Historical Names: |
Mid-South Home Health Agency, Inc.
|
| County: | Montgomery |
| Place of Formation: | Delaware |
| Principal Address: | 3350 RIVERWOOD PKY STE 1400ATLANTA, GA 30339 |
| Registered Office Street Address: | 2 NORTH JACKSON STREET SUITE 605MONTGOMERY, AL 36104 |
| Registered Office Street Address ZIP Code: | 36104 |
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EDHHBLGT8MT9 | 2024-08-13 | 2100 RIVERCHASE CTR STE 450, HOOVER, AL, 35244, 1897, USA | PO BOX 99767, CHICAGO, IL, 60696, USA | |||||||||||||||||||||||||||||||||||||||||
|
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| Doing Business As | CENTERWELL HOME HEALTH |
| Congressional District | 06 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2023-08-15 |
| Initial Registration Date | 2021-04-16 |
| Entity Start Date | 2006-05-28 |
| Fiscal Year End Close Date | Dec 31 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | DEBRA CARDIFF |
| Role | EDI ANALYST |
| Address | PO BOX 99767, CHICAGO, IL, 60696, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | DEBRA CARDIFF |
| Role | EDI ANALYST |
| Address | PO BOX 99767, CHICAGO, IL, 60696, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003067000 | 2008-10-08 | 2022-09-02 | 6330 SPRINT PKWY STE 300, OVERLAND PARK, KS, 662111157, US | 118 6TH ST S, CLANTON, AL, 350453540, US | |||||||||||||||||||
|
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| Phone | +1 205-755-9926 |
Authorized person
| Name | JOHN NICHOLS |
| Role | AUTHORIZED SIGNATORY |
| Phone | 2057559926 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 113425 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| C T CORPORATION SYSTEM | Agent | 2 NORHT JACKSON STREET SUITE 605MONTGOMERY, AL 36104 |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2013-01-04 | Name Change | Mid-South Home Health Agency, Inc. | Mid-South Home Health, LLC |
| 2004-09-15 | Name Merged | No data | Mid-South Home Health Agency, LLC |
Date of last update: 16 Aug 2024
Sources: Alabama Secretary of State
