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WoodLake Addiction Recovery of Mississippi, LLC

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Company Details

Name: WoodLake Addiction Recovery of Mississippi, LLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Dissolved
Effective Date: 20 Jul 2020 (5 years ago)
Business ID: 1225240
State of Incorporation: MISSISSIPPI
Principal Office Address: 8641 United Plaza BlvdBaton Rouge, LA 70809

Agent

Name Role Address
C. T. CORPORATION SYSTEM Agent 645 LAKELAND EAST DRIVE STE 101, FLOWOOD, MS 39232

Organizer

Name Role Address
R. Gray Sexton Organizer 8680 Bluebonnet Blvd., Suite D, Baton Rouge, LA 70810

Member

Name Role Address
David Roberts Member 8641 United Plaza Blvd, Baton Rouge, LA 70809
Randy Gomez Member 8641 United Plaza Blvd, Baton Rouge, LA 70809

National Provider Identifier

NPI Number:
1376157032
Certification Date:
2020-09-01

Authorized Person:

Name:
KENDALL MCCULLAR
Role:
CREDENTIALING SPECIALIST
Phone:

Taxonomy:

Selected Taxonomy:
324500000X - Substance Abuse Rehabilitation Facility
Is Primary:
Yes

Contacts:

Fax:
8555329362

Filings

Type Status Filed Date Description
Admin Dissolution Filed 2024-01-05 Action of Intent to Dissolve: AR: WoodLake Addiction Recovery of Mississippi, LLC
Notice to Dissolve/Revoke Filed 2023-09-08 Notice of Intent to Dissolve: AR: WoodLake Addiction Recovery of Mississippi, LLC
Annual Report LLC Filed 2022-04-13 Annual Report For WoodLake Addiction Recovery of Mississippi, LLC
Annual Report LLC Filed 2021-10-05 Annual Report For WoodLake Addiction Recovery of Mississippi, LLC
Notice to Dissolve/Revoke Filed 2021-09-07 Notice of Intent to Dissolve: AR: WoodLake Addiction Recovery of Mississippi, LLC
Correction Amendment Form Filed 2020-07-21 Correction For WoodLake Addiction Recovery of Mississippi, LLC
Formation Form Filed 2020-07-20 Formation For WoodLake Addiction Recovery of Mississippi, LLC

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Date of last update: 09 Jul 2025

Sources: Company Profile on Mississippi Secretary of State Website