| Entity Name: | GAINESVILLE PSYCHIATRY AND FORENSIC SERVICES, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 10 Oct 2005 (19 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 07 Sep 2016 (8 years ago) |
| Document Number: | L05000099470 |
| FEI/EIN Number | 203611957 |
| Address: | 1103 SW 2ND AVENUE, GAINESVILLE, FL, 32601, US |
| Mail Address: | 1103 SW 2ND AVENUE, GAINESVILLE, FL, 32601, US |
| ZIP code: | 32601 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295756385 | 2006-07-22 | 2018-08-06 | 1103 SW 2ND AVE, GAINESVILLE, FL, 326016116, US | 1103 SW 2ND AVE, GAINESVILLE, FL, 32601, US | |||||||||||||||||||||||||
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| Phone | +1 352-378-9116 |
| Fax | 3523789779 |
Authorized person
| Name | MRS. VICTORIA OZOEMEZINEM ADU |
| Role | BUSINESS MANAGER |
| Phone | 3523789116 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | ME84024 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 024658500 |
| State | FL |
| Name | Role |
|---|---|
| LEGALINC CORPORATE SERVICES INC. | Agent |
| Name | Role | Address |
|---|---|---|
| ADU LAWRENCE M | Managing Member | 19056 NW 75TH AVENUE, ALACHUA, FL, 32615 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000005760 | CEDAR HEALTHCARE | ACTIVE | 2012-01-17 | 2027-12-31 | No data | 1103 SW 2ND AVE, GAINESVILLE, FL, 32601 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2022-12-05 | 476 RIVERSIDE AVE., JACKSONVILLE, FL 32202 | No data |
| LC STMNT OF RA/RO CHG | 2016-09-07 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-09-07 | LEGALINC CORPORATE SERVICES INC. | No data |
| CHANGE OF MAILING ADDRESS | 2013-03-27 | 1103 SW 2ND AVENUE, GAINESVILLE, FL 32601 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-03-28 | 1103 SW 2ND AVENUE, GAINESVILLE, FL 32601 | No data |
| AMENDMENT | 2005-11-28 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-14 |
| ANNUAL REPORT | 2023-04-29 |
| ANNUAL REPORT | 2022-04-20 |
| ANNUAL REPORT | 2021-04-14 |
| ANNUAL REPORT | 2020-06-16 |
| ANNUAL REPORT | 2019-04-09 |
| ANNUAL REPORT | 2018-04-14 |
| ANNUAL REPORT | 2017-04-28 |
| CORLCRACHG | 2016-09-07 |
| ANNUAL REPORT | 2016-04-28 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
