| Entity Name: | FULL CIRCLE BEHAVIORAL HEALTH SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 31 May 2013 (12 years ago) |
| Last Event: | LC NAME CHANGE |
| Event Date Filed: | 30 Oct 2017 (7 years ago) |
| Document Number: | L13000079124 |
| FEI/EIN Number | 46-2924811 |
| Address: | 7151 Mailler St, Orlando, FL, 32818, US |
| Mail Address: | 7151 Mailler St, Orlando, FL, 32818, US |
| ZIP code: | 32818 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073029252 | 2017-12-25 | 2017-12-25 | 7151 MAILLER ST, ORLANDO, FL, 328188861, US | 7151 MAILLER ST, ORLANDO, FL, 328188861, US | |||||||||||||||||||||||
|
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| Phone | +1 407-716-7668 |
Authorized person
| Name | BARBARA JO FULLER |
| Role | MENTAL HEALTH COUNSELOR |
| Phone | 4077167668 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | L13000079124 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1790091346 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Fuller Barbara | Agent | 7151 Mailler St, Orlando, FL, 32818 |
| Name | Role | Address |
|---|---|---|
| Fuller Barbara | Managing Member | 7151 Mailler St, Orlando, FL, 32818 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2022-02-09 | Fuller, Barbara | No data |
| LC NAME CHANGE | 2017-10-30 | FULL CIRCLE BEHAVIORAL HEALTH SERVICES, LLC | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-01-09 | 7151 Mailler St, Orlando, FL 32818 | No data |
| CHANGE OF MAILING ADDRESS | 2015-01-09 | 7151 Mailler St, Orlando, FL 32818 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-01-09 | 7151 Mailler St, Orlando, FL 32818 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-01 |
| ANNUAL REPORT | 2023-02-21 |
| ANNUAL REPORT | 2022-02-09 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-01-17 |
| ANNUAL REPORT | 2019-02-15 |
| ANNUAL REPORT | 2018-01-16 |
| LC Name Change | 2017-10-30 |
| ANNUAL REPORT | 2017-03-25 |
| ANNUAL REPORT | 2016-04-29 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
