| Entity Name: | BEHAVIOR COACH, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
BEHAVIOR COACH, PLLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 06 Apr 2010 (15 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 12 Nov 2012 (12 years ago) |
| Document Number: | L10000036792 |
| FEI/EIN Number |
38-3812721
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | TELEHEALTH, TAMPA, FL, 33629, US |
| Mail Address: | 12100 Infinity Dr, New Port Richey, FL, 34654, US |
| ZIP code: | 33629 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1316507536 | 2019-06-19 | 2019-06-19 | 12100 INFINITY DR, NEW PORT RICHEY, FL, 346542040, US | 3825 HENDERSON BLVD STE 401, TAMPA, FL, 336295022, US | |||||||||||||||||||
|
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| Phone | +1 727-389-1667 |
Authorized person
| Name | JACQUELINE NEYSA BUCKLE |
| Role | OWNER |
| Phone | 7273891667 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1487635520 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BUCKLE JACQUELINE N | Managing Member | 12100 Infinity Dr, New Port Richey, FL, 34654 |
| BUCKLE JACQUELINE N | Agent | 12100 Infinity Dr, New Port Richey, FL, 34654 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-19 | TELEHEALTH, TAMPA, FL 33629 | - |
| CHANGE OF MAILING ADDRESS | 2021-04-19 | TELEHEALTH, TAMPA, FL 33629 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2021-04-19 | 12100 Infinity Dr, New Port Richey, FL 34654 | - |
| REINSTATEMENT | 2012-11-12 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-18 |
| ANNUAL REPORT | 2023-04-18 |
| ANNUAL REPORT | 2022-04-19 |
| ANNUAL REPORT | 2021-04-19 |
| ANNUAL REPORT | 2020-03-05 |
| ANNUAL REPORT | 2019-03-04 |
| ANNUAL REPORT | 2018-04-28 |
| ANNUAL REPORT | 2017-04-27 |
| ANNUAL REPORT | 2016-04-05 |
| ANNUAL REPORT | 2015-04-06 |
Date of last update: 01 May 2025
Sources: Florida Department of State
