| Name: | Mitchell's Place, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Non-Profit Corporation |
| Status: | Exists |
| Date of registration: | 28 Apr 2004 (21 years ago) |
| Entity Number: | 000-559-898 |
| Register Number: | 000559898 |
| ZIP code: | 35242 |
| County: | Shelby |
| Place of Formation: | Jefferson County |
| Principal Address: | BIRMINGHAM, AL |
| Registered Office Street Address: | 100 VILLAGE STBIRMINGHAM, AL 35242 |
Activities
AFTER SCHOOL PROGRAM/DAY CARE FOR CHILDREN DEVELOPMENTAL DISABLE
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SJB4JW57JTB8 | 2025-04-03 | 4778 OVERTON RD, BIRMINGHAM, AL, 35210, 3803, USA | 4778 OVERTON RD, BIRMINGHAM, AL, 35210, 3803, USA | |||||||||||||||||||||||||||||||||||||||||||
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| Division Name | MITCHELL'S PLACE, INC |
| Congressional District | 06 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2024-04-05 |
| Initial Registration Date | 2021-11-11 |
| Entity Start Date | 2004-04-28 |
| Fiscal Year End Close Date | Dec 31 |
Service Classifications
| NAICS Codes | 611699, 611710 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | SARA NALL |
| Role | EXECUTIVE DIRECTOR |
| Address | 4778 OVERTON RD, BIRMINGHAM, AL, 35210, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | SARA NALL |
| Role | EXECUTIVE DIRECTOR |
| Address | 4778 OVERTON RD, BIRMINGHAM, AL, 35210, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1235263419 | 2007-03-16 | 2024-05-23 | 4778 OVERTON ROAD, BIRMINGHAM, AL, 35210, US | 4778 OVERTON ROAD, BIRMINGHAM, AL, 35210, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 205-957-0294 |
| Fax | 2059570298 |
Authorized person
| Name | DARRELL W FITZGERALD |
| Role | BILLING DIRECTOR |
| Phone | 2059570294 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | Yes |
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| Is Primary | No |
| Taxonomy Code | 2084P0804X - Child & Adolescent Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 225X00000X - Occupational Therapist |
| Is Primary | No |
| Taxonomy Code | 225XF0002X - Feeding, Eating & Swallowing Occupational Therapist |
| Is Primary | No |
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 247019 |
| State | AL |
| Name | Role |
|---|---|
| MEISLER, ALLEN | Agent |
| Name | Role | Address |
|---|---|---|
| LEVITT, RONALD A | Incorporator | PO BOX 55727BIRMINGHAM, AL 35255-5727 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
