| Entity Name: | FAMILY THERAPY ASSOCIATES OF JACKSONVILLE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 09 Jan 2013 (12 years ago) |
| Document Number: | L13000004519 |
| FEI/EIN Number | 46-1729641 |
| Address: | 4686 Sunbeam Road, JACKSONVILLE, FL 32257 |
| Mail Address: | 4686 Sunbeam Road, JACKSONVILLE, FL 32257 |
| ZIP code: | 32257 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295075190 | 2013-03-01 | 2016-11-08 | 2950 HALCYON LN STE 605, JACKSONVILLE, FL, 322236692, US | 2950 HALCYON LN STE 605, JACKSONVILLE, FL, 322236692, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 904-302-5340 |
| Fax | 9048001211 |
Authorized person
| Name | DR. TABITHA JOHNSON |
| Role | OWNER/MANAGER |
| Phone | 9043025340 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| License Number | MT2673 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FAMILY THERAPY ASSOCIATES OF JACKSONVILLE 401(K) PLAN | 2023 | 461729641 | 2024-05-09 | FAMILY THERAPY ASSOCIATES OF JACKSONVILLE, LLC | 11 | |||||||||||||||||||||||
|
||||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2024-05-09 |
| Name of individual signing | TABITHA JOHNSON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-01-01 |
| Business code | 621330 |
| Sponsor’s telephone number | 9043025340 |
| Plan sponsor’s address | 2950 HALCYON LANE, SUITE 605, JACKSONVILLE, FL, 32223 |
Signature of
| Role | Plan administrator |
| Date | 2023-08-28 |
| Name of individual signing | TABITHA JOHNSON |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| JOHNSON, TABITHA R | Agent | 1873 Green Island Circle, Orange Park, FL 32065 |
| Name | Role | Address |
|---|---|---|
| JOHNSON, TABITHA R, Dr. | Managing Member | 1873 Green Island Circle, Orange Park, FL 32065 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-24 | 4686 Sunbeam Road, JACKSONVILLE, FL 32257 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-24 | 4686 Sunbeam Road, JACKSONVILLE, FL 32257 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-04-02 | 1873 Green Island Circle, Orange Park, FL 32065 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-24 |
| ANNUAL REPORT | 2023-03-09 |
| ANNUAL REPORT | 2022-04-08 |
| ANNUAL REPORT | 2021-03-04 |
| ANNUAL REPORT | 2020-03-24 |
| ANNUAL REPORT | 2019-04-02 |
| ANNUAL REPORT | 2018-02-10 |
| ANNUAL REPORT | 2017-01-07 |
| ANNUAL REPORT | 2016-03-13 |
| ANNUAL REPORT | 2015-01-21 |
Date of last update: 22 Feb 2025
Sources: Florida Department of State
