| Name: | Grace Health and Wellness Family Clinic |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Non-Profit Corporation |
| Status: | Exists |
| Date of registration: | 18 Jun 2024 (5 months ago) (Companies founded in June 2024) |
| Entity Number: | 001-141-393 |
| Register Number: | 001141393 |
| ZIP code: | 35601 (Companies in Morgan, 35601) |
| County: | Morgan |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 443 Pine Avenue SWDecatur, AL 35601 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184454795 | 2024-08-07 | 2024-08-07 | PO BOX 5393, DECATUR, AL, 356010393, US | 443 PINE AVE SW, DECATUR, AL, 356017631, US | |||||||||||||||||||
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| Phone | +1 256-203-5713 |
| Fax | 2562609544 |
Authorized person
| Name | TIFFANIE M MCGUIRE |
| Role | CRNP |
| Phone | 2562035713 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| Marshall, Tiffanie | Director | 443 Pine Avenue SWDecatur, AL 35601 |
| Smith, Sarah | Director | 13065 Alabama Hwy. 68Crossville, AL 35962 |
| Cater, Tracey | Director | 3306 Sandlin Road SWDecatur, AL 35603 |
| Name | Role | Address |
|---|---|---|
| Marshall, Tiffanie | Agent | 443 Pine Avenue SWDecatur, AL 35601 |
| Name | Role | Address |
|---|---|---|
| Marshall, Tiffanie | Incorporator | 443 Pine Avenue SWDecatur, AL 35601 |
Date of last update: 18 Aug 2024
Sources: Alabama Secretary of State
