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BEACON PEDIATRIC BEHAVIORAL HEALTH, LLC - Florida Company Profile

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Company Details

Entity Name: BEACON PEDIATRIC BEHAVIORAL HEALTH, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 12 Jul 2012 (13 years ago)
Document Number: L12000091102
FEI/EIN Number 46-0549337
Address: 6816 Southpoint Parkway, Jacksonville, FL, 32216, US
Mail Address: 6816 Southpoint Parkway, Jacksonville, FL, 32216, US
ZIP code: 32216
City: Jacksonville
County: Duval
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
DESANTIS KING ADRIENNE Managing Member 2754 CHAPMAN OAK DR., JACKSONVILLE, FL, 32257
NABIZADEH PARAS Managing Member 14091 CAHABA RD, JACKSONVILLE, FL, 32224
DeSantis King Adrienne Agent 6816 Southpoint Parkway, JACKSONVILLE, FL, 32216

National Provider Identifier

NPI Number:
1770838872

Authorized Person:

Name:
DR. ADRIENNE LEIGH DESANTIS KING
Role:
MANAGING MEMBER/OWNER/PSYCHOLOGIST
Phone:

Taxonomy:

Selected Taxonomy:
103K00000X - Behavior Analyst
Is Primary:
No
Selected Taxonomy:
103T00000X - Psychologist
Is Primary:
Yes

Contacts:

Fax:
9049007732

Form 5500 Series

Employer Identification Number (EIN):
460549337
Plan Year:
2024
Number Of Participants:
10
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
7
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
7
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
9
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
6
Sponsors Telephone Number:

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2019-04-03 DeSantis King, Adrienne -
REGISTERED AGENT ADDRESS CHANGED 2019-04-03 6816 Southpoint Parkway, Suite 202, JACKSONVILLE, FL 32216 -
CHANGE OF PRINCIPAL ADDRESS 2016-03-27 6816 Southpoint Parkway, Suite 202, Jacksonville, FL 32216 -
CHANGE OF MAILING ADDRESS 2016-03-27 6816 Southpoint Parkway, Suite 202, Jacksonville, FL 32216 -

Documents

Name Date
ANNUAL REPORT 2024-05-15
ANNUAL REPORT 2023-01-19
ANNUAL REPORT 2022-01-25
ANNUAL REPORT 2021-04-24
ANNUAL REPORT 2020-07-18
ANNUAL REPORT 2019-04-03
ANNUAL REPORT 2018-04-28
ANNUAL REPORT 2017-04-29
ANNUAL REPORT 2016-03-27
ANNUAL REPORT 2015-04-08

USAspending Awards / Financial Assistance

Date:
2020-04-29
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
102248.45
Total Face Value Of Loan:
102248.45

Paycheck Protection Program

Jobs Reported:
12
Initial Approval Amount:
$102,248.45
Date Approved:
2020-04-28
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$102,248.45
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$103,111.26
Servicing Lender:
VyStar CU
Use of Proceeds:
Payroll: $94,448.45
Utilities: $1,000
Rent: $6,800

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Date of last update: 01 Aug 2025

Sources: Florida Department of State