| Entity Name: | DRT BEHAVIORAL SERVICES "PLLC" |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 15 Feb 2013 (12 years ago) |
| Document Number: | L13000024612 |
| FEI/EIN Number | 46-1983772 |
| Address: | 2699 Stirling Road, #C407, Unit C407, Ft. Lauderdale, FL 33312 |
| Mail Address: | 2699 Stirling Road, #C407, #C407, Ft. Lauderdale, FL 33312 |
| ZIP code: | 33312 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063856938 | 2013-04-23 | 2020-08-07 | 2699 STIRLING ROAD, SUITE C407, FORT LAUDERDALE, FL, 33312, US | 2699 STIRLING RD, SUITE C407, FORT LAUDERDALE, FL, 33312, US | |||||||||||||||||||||||
|
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| Phone | +1 305-981-1700 |
Authorized person
| Name | DELVENA RENEE THOMAS |
| Role | OWNER |
| Phone | 3059811700 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | OS10439 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009939900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| THOMAS, DELVENA R | Agent | 2699 Stirling Road, #C407, Unit C407, Ft. Lauderdale, FL 33312 |
| Name | Role | Address |
|---|---|---|
| THOMAS, DELVENA R | Manager | 2699 Stirling Road, #C407, Unit C407 Ft. Lauderdale, FL 33312 |
| DUNMEYER, TAJAI A | Manager | 2699 Stirling Road, #C407, Unit C407 Ft. Lauderdale, FL 33312 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000080343 | DRT BEHAVIORAL SERVICES - BRAIN LOVE | EXPIRED | 2017-07-27 | 2022-12-31 | No data | STE C407, FORT LAUDERDALE, FL, 33312 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2017-04-14 | 2699 Stirling Road, #C407, Unit C407, Ft. Lauderdale, FL 33312 | No data |
| CHANGE OF MAILING ADDRESS | 2017-04-14 | 2699 Stirling Road, #C407, Unit C407, Ft. Lauderdale, FL 33312 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-04-14 | 2699 Stirling Road, #C407, Unit C407, Ft. Lauderdale, FL 33312 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-23 |
| ANNUAL REPORT | 2023-01-19 |
| ANNUAL REPORT | 2022-03-10 |
| ANNUAL REPORT | 2021-01-16 |
| ANNUAL REPORT | 2020-07-01 |
| ANNUAL REPORT | 2019-05-01 |
| ANNUAL REPORT | 2018-04-27 |
| ANNUAL REPORT | 2017-04-14 |
| ANNUAL REPORT | 2016-03-17 |
| ANNUAL REPORT | 2015-04-29 |
Date of last update: 22 Jan 2025
Sources: Florida Department of State
