| Entity Name: | KEY WEST BEHAVIORAL HEALTH, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Profit Corporation |
| Status: | Inactive |
| Date Filed: | 14 Jul 2009 (16 years ago) |
| Date of dissolution: | 27 Dec 2011 (13 years ago) |
| Last Event: | WITHDRAWAL |
| Event Date Filed: | 27 Dec 2011 (13 years ago) |
| Document Number: | F09000002817 |
| FEI/EIN Number | 27-0159185 |
| Address: | 1200 KENNEDY DRIVE, SUITE 109, KEY WEST, FL 33040 |
| Mail Address: | PO BOX 882452, PORT SAINT LUCIE, FL 34988 |
| ZIP code: | 33040 |
| County: | Monroe |
| Place of Formation: | NEVADA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891924924 | 2009-07-10 | 2009-07-10 | 1200 KENNEDY DR, KEY WEST, FL, 330404023, US | 1200 KENNEDY DR, KEY WEST, FL, 330404023, US | |||||||||||||||||||||||||
|
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| Phone | +1 305-294-5592 |
| Fax | 3052945594 |
Authorized person
| Name | CARA M YERGEN |
| Role | OWNER/MD |
| Phone | 3052945592 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | ME100952 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAL LICENSE |
| Number | ME100952 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| YERGEN, CARA MD | President | 1200 KENNEDY DRIVE, SUITE 109, KEY WEST, FL 33040 |
| Name | Role | Address |
|---|---|---|
| YERGEN, CARA MD | Treasurer | 1200 KENNEDY DRIVE, SUITE 109, KEY WEST, FL 33040 |
| Name | Role | Address |
|---|---|---|
| YERGEN, CARA MD | Director | 1200 KENNEDY DRIVE, SUITE 109, KEY WEST, FL 33040 |
| Name | Role | Address |
|---|---|---|
| YERGEN, CARA MD | Secretary | 1200 KENNEDY DRIVE, SUITE 109, KEY WEST, FL 33040 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| WITHDRAWAL | 2011-12-27 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2011-12-27 | 1200 KENNEDY DRIVE, SUITE 109, KEY WEST, FL 33040 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-01-14 | 1200 KENNEDY DRIVE, SUITE 109, KEY WEST, FL 33040 | No data |
| Name | Date |
|---|---|
| WITHDRAWAL | 2011-12-27 |
| ANNUAL REPORT | 2011-01-05 |
| ANNUAL REPORT | 2010-01-14 |
| Foreign Profit | 2009-07-14 |
Date of last update: 24 Feb 2025
Sources: Florida Department of State
