| Name: | Coosa Valley Healthcare Center, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Series Limited Liability Company |
| Status: | Exists |
| Date of registration: | 29 May 2018 (7 years ago) |
| Entity Number: | 000-519-806 |
| Register Number: | 000519806 |
| ZIP code: | 36853 |
| County: | Tallapoosa |
| Place of Formation: | Tallapoosa County |
| Registered Office Street Address: | 314 WEST COLUMBUS STREETDADEVILLE, AL 36853 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013401132 | 2018-06-21 | 2018-06-21 | 314 W COLUMBUS ST, DADEVILLE, AL, 368531337, US | 315 W HICKORY ST, SYLACAUGA, AL, 351502913, US | |||||||||||||||||||||||
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| Phone | +1 256-825-9274 |
| Fax | 2568259276 |
| Phone | +1 256-401-4324 |
| Fax | 2564014696 |
Authorized person
| Name | THOMAS GILLILAND |
| Role | REGIONAL FINANCIAL CONSULTANT |
| Phone | 2568259274 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 18101 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| CHAPMAN, ARCHIE J | Agent |
| Name | Role | Address |
|---|---|---|
| WEBSTER, J LANCE | Organizer | 1130 22ND STREET SOUTH STE 4000BIRMINGHAM, AL 35205 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
