The Mental Health Board of Bibb, Pickens, and Tuscaloosa Counties, Inc.

Details

Name:	The Mental Health Board of Bibb, Pickens, and Tuscaloosa Counties, Inc.
Jurisdiction:	Alabama
Legal type:	Domestic Non-Profit Corporation
Status:	Exists
Date of registration:	12 Nov 1969 (55 years ago)
Entity Number:	000-070-223
Register Number:	000070223
Historical Names:	Mental Health Board of Bibb, Pickens & Tuscaloosa Counties, Inc. Mental Health/Mental Retardation Board of Bibb, Pickens & Tuscaloosa Counties, Inc.
Place of Formation:	Tuscaloosa County

Unique Entity ID

Expiration Date

Physical Address

Mailing Address

LNZ1DHYPMSA5

2024-09-13

2209 9TH ST, TUSCALOOSA, AL, 35401, 2300, USA

2209 9TH STREET, TUSCALOOSA, AL, 35401, 2300, USA

Business Information

Congressional District	07
State/Country of Incorporation	AL, USA
Activation Date	2023-09-18
Initial Registration Date	2018-04-27
Entity Start Date	1969-11-12
Fiscal Year End Close Date	Sep 30

Points of Contacts

Electronic Business
Title	PRIMARY POC
Name	CHERYL DUBOSE
Role	CLINICAL DIRECTOR
Address	2209 9TH STREET, TUSCALOOSA, AL, 35401, 2300, USA

Title	ALTERNATE POC
Name	SANDY CAMPBELL
Role	CFO
Address	2209 9TH STREET, TUSCALOOSA, AL, 35401, USA

Government Business
Title	PRIMARY POC
Name	KAREN JONES
Role	EXECUTIVE DIRECTOR
Address	2209 9TH STREET, TUSCALOOSA, AL, 35401, 2300, USA

Past Performance
Title	PRIMARY POC
Name	KAREN JONES
Role	CLINICAL DIRECTOR
Address	2209 9TH STREET, TUSCALOOSA, AL, 35401, USA

National Provider Identifier

NPI

Enumeration Date

Last Update Date

Mailing Address

Practice Location Address

1285809194

2008-04-23

2022-07-21

PO BOX 2190, TUSCALOOSA, AL, 354032190, US

1915 6TH ST, TUSCALOOSA, AL, 354011722, US

Contacts

Phone	+1 205-562-3700
Fax	2055623769

Authorized person

Name	MR. JAMES MOORE
Role	EXECUTIVE DIRECTOR
Phone	2055623700

Taxonomy

Taxonomy Code	261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center)
State	AL
Is Primary	Yes

Other Provider Identifiers

Issuer	MEDICAID
Number	528700510
State	AL
Issuer	BCBS OF AL
Number	051008111
State	AL
Issuer	BCBS OF AL
Number	051511693
State	AL

Incorporator

Name	Role
BEVERAGE, BILL O	Incorporator
OWENS, BEATRICE	Incorporator
PEAK, VIRGIL	Incorporator

Events

Event Date	Event Type	Old Value	New Value
2015-06-02	Name Change	Mental Health/Mental Retardation Board of Bibb, Pickens & Tuscaloosa Counties, Inc.	The Mental Health Board of Bibb, Pickens, and Tuscaloosa Counties, Inc.
1979-07-13	Name Change	Mental Health Board of Bibb, Pickens & Tuscaloosa Counties, Inc.	Mental Health/Mental Retardation Board of Bibb, Pickens & Tuscaloosa Counties, Inc.

Paycheck Protection Program

Loan Number

Loan Funded Date

SBA Origination Office Code

Loan Delivery Method

Borrower Street Address

7494047007

2020-04-07

0459

PPP

2209 9th Street, TUSCALOOSA, AL, 35401-2300

Loan Status Date	2020-06-04
Loan Status	Paid in Full
Loan Maturity in Months	24
SBA Guaranty Percentage	100
Loan Approval Amount (at origination)	1715759.62
Loan Approval Amount (current)	1715759.62
Undisbursed Amount	0
Franchise Name	-
Lender Location ID	434580
Servicing Lender Name	Bryant Bank
Servicing Lender Address	1550 McFarland Blvd North, TUSCALOOSA, AL, 35406-2211
Rural or Urban Indicator	U
Hubzone	Y
LMI	Y
Business Age Description	Existing or more than 2 years old
Project Address	TUSCALOOSA, TUSCALOOSA, AL, 35401-2300
Project Congressional District	AL-07
Number of Employees	216
NAICS code	623220
Borrower Race	Unanswered
Borrower Ethnicity	Unknown/NotStated
Business Type	Non-Profit Organization
Originating Lender ID	434580
Originating Lender Name	Bryant Bank
Originating Lender Address	TUSCALOOSA, AL
Gender	Unanswered
Veteran	Unanswered
Forgiveness Amount	1729485.7
Forgiveness Paid Date	2021-01-27

Date of last update: 31 Jul 2024

Sources: Alabama Secretary of State