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SPRUCE CREEK MENTAL HEALTH SERVICES, LLC - Florida Company Profile

Company Details

Entity Name: SPRUCE CREEK MENTAL HEALTH SERVICES, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

SPRUCE CREEK MENTAL HEALTH SERVICES, LLC 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.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

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: 03 Jan 2013 (12 years ago)
Document Number: L13000001579
FEI/EIN Number 46-1680921

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 6117 Del Rio Drive, PORT ORANGE, FL, 32127, US
Mail Address: 6117 Del Rio Drive, PORT ORANGE, FL, 32127, US
ZIP code: 32127
County: Volusia
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1669710273 2013-01-17 2013-02-01 6112 PALMAS DR, PORT ORANGE, FL, 321276751, US 1690 DUNLAWTON AVE, SUITE 125, PORT ORANGE, FL, 321278979, US

Contacts

Phone +1 386-681-8639
Fax 3863103992

Authorized person

Name MR. EDWARD C KING
Role OWNER
Phone 3866818639

Taxonomy

Taxonomy Code 1041C0700X - Clinical Social Worker
License Number SW10520
State FL
Is Primary Yes

Key Officers & Management

Name Role Address
KING SHANNON Managing Member 164 Avocet Court, Daytona Beach, FL, 32119
KING EDWARD Managing Member 6117 del Rio Drive, PORT ORANGE, FL, 32127
KING EDWARD Agent 6117 Del Rio Drive, PORT ORANGE, FL, 32127

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G14000130006 SPRUCE CREEK COUNSELING SERVICES EXPIRED 2014-12-26 2019-12-31 - 6112 PALMAS DRIVE, PORT ORANGE, FL, 32127

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2025-01-22 1690 Dunlawton Ave, Suite 125, PORT ORANGE, FL 32127 -
CHANGE OF MAILING ADDRESS 2025-01-22 1690 Dunlawton Ave, Suite 125, PORT ORANGE, FL 32127 -
REGISTERED AGENT ADDRESS CHANGED 2025-01-22 1690 Dunlawton Ave, Suite 125, PORT ORANGE, FL 32127 -
CHANGE OF PRINCIPAL ADDRESS 2023-04-04 6117 Del Rio Drive, PORT ORANGE, FL 32127 -
CHANGE OF MAILING ADDRESS 2023-04-04 6117 Del Rio Drive, PORT ORANGE, FL 32127 -
REGISTERED AGENT ADDRESS CHANGED 2023-04-04 6117 Del Rio Drive, PORT ORANGE, FL 32127 -

Documents

Name Date
ANNUAL REPORT 2025-01-22
ANNUAL REPORT 2024-04-23
ANNUAL REPORT 2023-04-04
ANNUAL REPORT 2022-03-02
ANNUAL REPORT 2021-04-15
ANNUAL REPORT 2020-03-30
ANNUAL REPORT 2019-04-29
ANNUAL REPORT 2018-03-08
ANNUAL REPORT 2017-03-07
ANNUAL REPORT 2016-04-28

Date of last update: 03 Apr 2025

Sources: Florida Department of State