| Entity Name: | METAMORPHOSIS LIFE REVITALIZING CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 29 Nov 2011 (13 years ago) |
| Document Number: | L11000134984 |
| FEI/EIN Number | 452936974 |
| Address: | 5470 E. Busch Blvd, TEMPLE TERRACE, FL, 33617, US |
| Mail Address: | 5470 E. Busch Blvd, TEMPLE TERRACE, FL, 33617, US |
| ZIP code: | 33617 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356755060 | 2014-06-20 | 2014-06-20 | 8430 MONTRAVAIL CIR, #313, TEMPLE TERRACE, FL, 336373024, US | 11700 N 58TH ST, SUITE J, TEMPLE TERRACE, FL, 336171666, US | |||||||||||||||||||
|
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| Phone | +1 813-703-2256 |
| Fax | 8135128904 |
Authorized person
| Name | DR. APRIL MICHELLE JACKSON-JAMES |
| Role | MANAGING PARTNER |
| Phone | 8137032256 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY8197 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Jackson-James April MPhd | Agent | 5470 E. Busch Blvd, TEMPLE TERRACE, FL, 33617 |
| Name | Role | Address |
|---|---|---|
| JAMES MICHAEL LJr. | Manager | 5470 E. Busch Blvd, TEMPLE TERRACE, FL, 33617 |
| JACKSON-JAMES APRIL MDr. | Manager | 5470 E. Busch Blvd, TEMPLE TERRACE, FL, 33617 |
| Stewart Janet RLMHC | Manager | 5470 E. Busch Blvd, TEMPLE TERRACE, FL, 33617 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-03-30 | 5470 E. Busch Blvd, Unit 406, TEMPLE TERRACE, FL 33617 | No data |
| CHANGE OF MAILING ADDRESS | 2021-03-30 | 5470 E. Busch Blvd, Unit 406, TEMPLE TERRACE, FL 33617 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-03-30 | 5470 E. Busch Blvd, Unit 406, TEMPLE TERRACE, FL 33617 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-04-17 | Jackson-James, April M., Phd | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-21 |
| ANNUAL REPORT | 2022-04-08 |
| ANNUAL REPORT | 2021-03-30 |
| ANNUAL REPORT | 2020-03-27 |
| ANNUAL REPORT | 2019-04-04 |
| ANNUAL REPORT | 2018-03-26 |
| ANNUAL REPORT | 2017-04-17 |
| ANNUAL REPORT | 2016-03-09 |
| ANNUAL REPORT | 2015-04-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
