| Entity Name: | DEEP RIVER PSYCHOLOGICAL SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 05 Nov 2007 (17 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 19 Oct 2012 (12 years ago) |
| Document Number: | L07000112096 |
| FEI/EIN Number | 261362225 |
| Address: | 1012 California Creek Drive, Oviedo, FL, 32765, UN |
| Mail Address: | 1012 California Creek Drive, Oviedo, FL, 32765, UN |
| ZIP code: | 32765 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386086726 | 2013-07-26 | 2013-08-15 | 323 10TH AVE W, SUITE 302, PALMETTO, FL, 342215047, US | 323 10TH AVE W, SUITE 302, PALMETTO, FL, 342215047, US | |||||||||||||||||||
|
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| Phone | +1 941-721-6325 |
| Fax | 9417236741 |
Authorized person
| Name | DR. JENNIFER H MENDOZA |
| Role | OWNER/PSYCHOLOGIST |
| Phone | 9417216325 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | PY5572 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MENDOZA JENNIFER H | Agent | 1012 California Creek Drive, Oviedo, FL, 32765 |
| Name | Role | Address |
|---|---|---|
| MENDOZA JENNIFER H | Manager | 1012 California Creek Drive, Oviedo, FL, 32765 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-01 | 1012 California Creek Drive, Oviedo, FL 32765 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-07-19 | 1012 California Creek Drive, Oviedo, FL 32765 UN | No data |
| CHANGE OF MAILING ADDRESS | 2023-07-19 | 1012 California Creek Drive, Oviedo, FL 32765 UN | No data |
| REINSTATEMENT | 2012-10-19 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2012-10-19 | MENDOZA, JENNIFER HPHD | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-01 |
| ANNUAL REPORT | 2023-02-13 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-02-01 |
| ANNUAL REPORT | 2020-03-25 |
| ANNUAL REPORT | 2019-01-29 |
| ANNUAL REPORT | 2018-01-17 |
| ANNUAL REPORT | 2017-03-08 |
| ANNUAL REPORT | 2016-01-22 |
| ANNUAL REPORT | 2015-01-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
