| Name: | BLUEBIRD PEDIATRIC THERAPY SERVICES, INC. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 03 Jun 2011 (14 years ago) |
| Entity Number: | 000-015-472 |
| Register Number: | 000015472 |
| ZIP code: | 36608 |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Registered Office Street Address: | 6175 AIRPORT BOULEVARD, SUITE 205MOBILE, AL 36608 |
| Principal Address: | 6157 Airport BlvdSuite 205MOBILE, AL 36608 |
| Authorized Capital: | 1,000,000 |
Activities
Multi-disciplinary therapy clinic
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | BLUEBIRD PEDIATRIC THERAPY SERVICES, INC., MISSISSIPPI | 1444363 | MISSISSIPPI |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619255460 | 2011-07-27 | 2011-09-07 | 6312 PICCADILLY SQUARE DR, SUITE 3, MOBILE, AL, 366095143, US | 6312 PICCADILLY SQUARE DR, SUITE 3, MOBILE, AL, 366095143, US | |||||||||||||||||||||||||
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| Phone | +1 251-287-0378 |
| Fax | 2512870466 |
Authorized person
| Name | MRS. DANIELLE M PETERS |
| Role | OWNER/PEDIATRIC OT |
| Phone | 2517531613 |
Taxonomy
| Taxonomy Code | 261QR0400X - Rehabilitation Clinic/Center |
| License Number | 3077 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 130837 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| PETERS, DANIELLE M | Director | 260 PARK AVENUEMOBILE, AL 36607 |
| John Peters | Director | 172 Opal LaneLucedale, MS 39452 |
| Name | Role | Address |
|---|---|---|
| PETERS, DANIELLE M | Incorporator | 260 PARK AVENUEMOBILE, AL 36607 |
| Name | Role | Address |
|---|---|---|
| PETERS, DANIELLE | Agent | 7027 OLD MADISON PIKE SUITE 108HUNTSVILLE, AL 35806 |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
