| Name: | FAITH AND THERAPY, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 13 May 2022 (2 years ago) |
| Entity Number: | 001-019-867 |
| Register Number: | 001019867 |
| County: | Dale |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 1083 CO RD 25MIDLAND CITY, AL 36350 |
| Registered Office Street Address ZIP Code: | 36350 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639800477 | 2022-06-22 | 2022-06-22 | 1083 COUNTY ROAD 25, MIDLAND CITY, AL, 363506176, US | 187 BELMONT DR, DOTHAN, AL, 363056500, US | |||||||||||||||||||||
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| Phone | +1 334-790-9475 |
| Phone | +1 334-671-1280 |
Authorized person
| Name | AMANDA WRIGHT |
| Role | THERAPIST |
| Phone | 3347909475 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1811583735 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| WRIGHT, AMANDA | Agent | 1083 CO RD 25MIDLAND CITY, AL 36350 |
| Name | Role | Address |
|---|---|---|
| WRIGHT, AMANDA | Organizer | 1083 CO RD 25MIDLAND CITY, AL 36350 |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
