| Entity Name: | ENSO PSYCH GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 03 Jan 2007 (18 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 27 Sep 2021 (3 years ago) |
| Document Number: | L07000001691 |
| FEI/EIN Number | 208187316 |
| Address: | 1113 SOUTH MAGNOLIA DRIVE, TALLAHASSEE, FL, 32301, US |
| Mail Address: | 1113 SOUTH MAGNOLIA DRIVE, TALLAHASSEE, FL, 32301, US |
| ZIP code: | 32301 |
| County: | Leon |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265683551 | 2008-10-04 | 2019-06-11 | 1113 S MAGNOLIA DR, TALLAHASSEE, FL, 323014659, US | 1113 S MAGNOLIA DR, TALLAHASSEE, FL, 323014659, US | |||||||||||||||||||||
|
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| Phone | +1 850-778-1642 |
Authorized person
| Name | SION DOMAN |
| Role | MANAGER/MEMBER |
| Phone | 8507781642 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 001964700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DOMAN SION | Agent | 1113 SOUTH MAGNOLIA DRIVE, TALLAHASSEE, FL, 32301 |
| Name | Role | Address |
|---|---|---|
| DOMAN SION | Managing Member | 1113 SOUTH MAGNOLIA DRIVE, TALLAHASSEE, FL, 32301 |
| BAEZA ANGELICA | Managing Member | 1113 SOUTH MAGNOLIA DRIVE, TALLAHASSEE, FL, 32301 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2021-09-27 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REINSTATEMENT | 2018-10-02 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2018-10-02 | DOMAN, SION | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-03-22 | 1113 SOUTH MAGNOLIA DRIVE, TALLAHASSEE, FL 32301 | No data |
| CHANGE OF MAILING ADDRESS | 2017-03-22 | 1113 SOUTH MAGNOLIA DRIVE, TALLAHASSEE, FL 32301 | No data |
| LC NAME CHANGE | 2013-02-18 | ENSO PSYCH GROUP, LLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-04-28 | 1113 SOUTH MAGNOLIA DRIVE, TALLAHASSEE, FL 32301 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-01 |
| ANNUAL REPORT | 2023-04-28 |
| ANNUAL REPORT | 2022-02-09 |
| REINSTATEMENT | 2021-09-27 |
| ANNUAL REPORT | 2020-01-18 |
| ANNUAL REPORT | 2019-03-20 |
| REINSTATEMENT | 2018-10-02 |
| ANNUAL REPORT | 2017-03-22 |
| ANNUAL REPORT | 2016-03-29 |
| ANNUAL REPORT | 2015-04-29 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
