| Entity Name: | KIDS CONNECTION THERAPY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 09 Jan 2006 (19 years ago) |
| Document Number: | L06000002978 |
| FEI/EIN Number | 33-1129508 |
| Address: | 147 Parsons Road, Longwood, FL 32779 |
| Mail Address: | 147 Parsons Road, Longwood, FL 32779 |
| ZIP code: | 32779 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114691904 | 2021-08-04 | 2023-09-06 | 147 PARSONS RD, LONGWOOD, FL, 327792748, US | 147 PARSONS RD, LONGWOOD, FL, 327792748, US | |||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 407-721-3486 |
| Fax | 4076418633 |
Authorized person
| Name | NIKA CATHERINE PALCESKI |
| Role | MANAGING MEMBER |
| Phone | 4072524651 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | No |
| Taxonomy Code | 225X00000X - Occupational Therapist |
| Is Primary | No |
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| Is Primary | Yes |
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | No |
| Taxonomy Code | 252Y00000X - Early Intervention Provider Agency |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 003964300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Koltun, Jeffrey M | Agent | 150 Spartan Drive, Suite 100, Maitland, FL 32751 |
| Name | Role | Address |
|---|---|---|
| PALCESKI, NIKA C | Managing Member | 147 Parsons Road, Longwood, FL 32779 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2022-01-28 | 147 Parsons Road, Longwood, FL 32779 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-01-13 | Koltun, Jeffrey M | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-01-13 | 150 Spartan Drive, Suite 100, Maitland, FL 32751 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-02-09 | 147 Parsons Road, Longwood, FL 32779 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-17 |
| ANNUAL REPORT | 2023-01-10 |
| ANNUAL REPORT | 2022-01-28 |
| ANNUAL REPORT | 2021-01-13 |
| ANNUAL REPORT | 2020-01-17 |
| ANNUAL REPORT | 2019-02-09 |
| ANNUAL REPORT | 2018-01-10 |
| ANNUAL REPORT | 2017-01-21 |
| ANNUAL REPORT | 2016-02-20 |
| ANNUAL REPORT | 2015-01-20 |
Date of last update: 03 Jan 2025
Sources: Florida Department of State
