| Name: | Alabama Care Network Southeast |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Non-Profit Corporation |
| Status: | Exists |
| Date of registration: | 22 Jan 2019 (6 years ago) |
| Entity Number: | 000-540-618 |
| Register Number: | 000540618 |
| ZIP code: | 36832 |
| County: | Lee |
| Place of Formation: | Lee County |
| Registered Office Street Address: | 1445 SOUTH COLLEGE STREET SUITE 300AUBURN, AL 36832 |
Activities
EXCLUSIVELY CHARITABLE/RELIGIOUS/EDUCATIONAL/SCIENTIFIC PURPOSES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952122368 | 2024-10-18 | 2024-10-18 | 417 20TH ST N STE 1100, BIRMINGHAM, AL, 352033216, US | 1445 S COLLEGE ST STE 300, AUBURN, AL, 368325904, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 833-296-5246 |
Authorized person
| Name | ANNA VELASCO |
| Role | SECRETARY |
| Phone | 8332965245 |
Taxonomy
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | Yes |
| Taxonomy Code | 252Y00000X - Early Intervention Provider Agency |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| BLAXTON, ANGELA | Director | 364 HONEYSUCKLE ROADDOTHAN, AL 36305 |
| FUNCHES-JACKSON, KIMBERLY | Director | 1810 STADIUM DRIVE #210PHENIX CITY, AL 36867 |
| SCOTT, JONATHAN | Director | 1118 ROSS CLARK CIRCLE #600DOTHAN, AL 36301 |
| CANFILD, MICHAEL | Director | 890 NORTH DEAN ROADAUBURN, AL 36830 |
| KIRKLAND, MELISSA | Director | 3542 MONTGOMERY HWYDOTHAN, AL 36303 |
| ANDRUS, TERRY | Director | 2000 PEPPERELL PKWYOPELIKA, AL 36801 |
| MILLER, DEREK | Director | 1108 ROSS CLARK CIRCLEDOTHAN, AL 36301 |
| SCHOFIELD, DON | Director | 200 CHERRY STREETTROY, AL 36081 |
| MARINO, ROB | Director | 121 NORTH 20TH STREET #2OPELIKA, AL 36801 |
| Name | Role | Address |
|---|---|---|
| EASON, KIM | Agent | 1365 GATEWOOD DR SUITE 521AUBURN, AL 36830 |
| Name | Role | Address |
|---|---|---|
| EARNHARDT, CAMERON T | Incorporator | 701 20TH STREET SUITE 820BIRMINGHAM, AL 35233 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
