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PHOENIX TREATMENT CENTERS OUTPATIENT DIVISION LLC

Company Details

Name: PHOENIX TREATMENT CENTERS OUTPATIENT DIVISION LLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 01 Sep 2023 (2 years ago)
Organization Date: 01 Sep 2023 (2 years ago)
Managed By: Members
Organization Number: 1305246
ZIP code: 41653
City: Prestonsburg, Emma, Endicott, Hippo
Primary County: Floyd County
Principal Office: 286 US HIGHWAY 23 N, PRESTONSBURG, KY 41653
Place of Formation: KENTUCKY

Registered Agent

Name Role
AMBER SISCO Registered Agent

Organizer

Name Role
AMBER Organizer

National Provider Identifier

NPI Number:
1699551754
Certification Date:
2024-03-23

Authorized Person:

Name:
MRS. AMBER SISCO
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
324500000X - Substance Abuse Rehabilitation Facility
Is Primary:
No
Selected Taxonomy:
261QR0405X - Substance Use Disorder Rehabilitation Clinic/Center
Is Primary:
Yes

Contacts:

Filings

Name File Date
Administrative Dissolution 2024-10-12
Principal Office Address Change 2023-11-09
Articles of Organization 2023-09-01

Sources: Kentucky Secretary of State