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Shape Behavioral Services LLC

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Company Details

Name: Shape Behavioral Services LLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 08 Nov 2021 (4 years ago)
Organization Date: 08 Nov 2021 (4 years ago)
Managed By: Members
Organization Number: 1176424
ZIP code: 42141
City: Glasgow, Lamb
Primary County: Barren County
Principal Office: 625 S L Rogers Wells Blvd, #218, Glasgow, KY 42141
Place of Formation: KENTUCKY

Organizer

Name Role
Alexander Kiss Organizer

Registered Agent

Name Role
Alexander Kiss Registered Agent

National Provider Identifier

NPI Number:
1154088417
Certification Date:
2023-06-05

Authorized Person:

Name:
ALEX KISS
Role:
DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
106E00000X - Assistant Behavior Analyst
Is Primary:
No
Selected Taxonomy:
106S00000X - Behavior Technician
Is Primary:
No
Selected Taxonomy:
251S00000X - Community/Behavioral Health Agency
Is Primary:
No
Selected Taxonomy:
103K00000X - Behavior Analyst
Is Primary:
Yes

Contacts:

Filings

Name File Date
Administrative Dissolution 2022-10-04

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Sources: Kentucky Secretary of State