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Provision Home Corp

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Company Details

Name: Provision Home Corp
Legal type: Kentucky Corporation
Status: Inactive
Standing: Good
Profit or Non-Profit: Non-profit
File Date: 18 Oct 2023 (2 years ago)
Organization Date: 18 Oct 2023 (2 years ago)
Organization Number: 1315820
ZIP code: 40517
City: Lexington
Primary County: Fayette County
Principal Office: 138 E Reynolds Rd Ste 101, Lexington, KY 40517
Place of Formation: KENTUCKY

Director

Name Role
David Brian Bartley Director
Dustin Cornett Director
Angela Fahey Costa Director

Registered Agent

Name Role
Angela Fahey Costa Registered Agent

Incorporator

Name Role
Marissa Orlando Incorporator

National Provider Identifier

NPI Number:
1730950072
Certification Date:
2023-10-24

Authorized Person:

Name:
DAVID BRIAN BARTLEY
Role:
DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
175T00000X - Peer Specialist
Is Primary:
Yes

Contacts:

Filings

Name File Date
Dissolution 2024-03-18

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Sources: Kentucky Secretary of State