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Blue Water Recovery PLLC

Details

Name: Blue Water Recovery PLLC
Jurisdiction: Alabama
Legal type: Domestic Professional Limited Liability Company
Status: Dissolved
Date of registration: 01 Sep 2022 (2 years ago) (Companies founded in September 2022)
Date of dissolution: 05 Dec 2023
Entity Number: 001-037-991
Register Number: 001037991
ZIP code: 36527 (Companies in Baldwin, 36527)
County: Baldwin
Place of Formation: Alabama
Registered Office Street Address: 6580 Spanish Fort Blvd, Ste CSpanish Fort, AL 36527

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1699485078 2022-11-28 2023-02-15 112 W SECTION AVE STE 107, FOLEY, AL, 365353570, US 112 W SECTION AVE STE 107&108, FOLEY, AL, 365353570, US

Contacts

Phone +1 251-402-3488

Authorized person

Name DR. KELLY GARCIA
Role PRESIDENT
Phone 2514023488

Taxonomy

Taxonomy Code 2083A0300X - Addiction Medicine (Preventive Medicine) Physician
Is Primary Yes

Agent

Name Role
Langley, Thomas Agent

Organizer

Name Role Address
Garcia, Kelly Organizer 33998 Mendota DrSpanish Fort, AL 36527
Damaschun, Jason Organizer 33998 Mendota DrSpanish Fort, AL 36527

Date of last update: 17 Aug 2024

Sources: Alabama Secretary of State