| Name: | Magnolia Neuro Rehab, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 08 Sep 2022 (2 years ago) |
| Entity Number: | 001-038-895 |
| Register Number: | 001038895 |
| County: | Madison |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 106 FOX LAKE DRMADISON, AL 35758 |
| Registered Office Street Address ZIP Code: | 35758 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194441147 | 2022-10-12 | 2023-04-17 | 106 FOX LAKE DR, MADISON, AL, 357587963, US | 525 FOUNTAIN ROW SW, HUNTSVILLE, AL, 358014335, US | |||||||||||||||
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| Phone | +1 256-520-8306 |
| Phone | +1 256-513-9444 |
Authorized person
| Name | KELLEY E PACILLO |
| Role | OWNER/THERAPIST |
| Phone | 2565208306 |
Taxonomy
| Taxonomy Code | 225X00000X - Occupational Therapist |
| Is Primary | Yes |
| Name | Role |
|---|---|
| KELLEY E PACILLO | Agent |
| Name | Role | Address |
|---|---|---|
| Pacillo, Kelley | Organizer | 106 Fox Lake DrMadison, AL 35758 |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
