| Entity Name: | FIRST COAST COMMUNITY SUPPORT SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 04 Sep 2013 (11 years ago) |
| Date of dissolution: | 27 Sep 2024 (5 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (5 months ago) |
| Document Number: | L13000124369 |
| FEI/EIN Number | 463579133 |
| Address: | 1010 E. ADAMS STREET, SUITE 235, JACKSONVILLE, FL, 32202, US |
| Mail Address: | 1010 E. ADAMS STREET, SUITE 235, JACKSONVILLE, FL, 32202, US |
| ZIP code: | 32202 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184296832 | 2021-07-13 | 2021-07-13 | 5300 SAN JUAN AVE, JACKSONVILLE, FL, 322103142, US | 5300 SAN JUAN AVE, JACKSONVILLE, FL, 322103142, US | |||||||||||||||||||||
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| Phone | +1 904-738-8579 |
| Fax | 9046197835 |
Authorized person
| Name | DENISE BOYD |
| Role | ADMINISTRATOR |
| Phone | 9047388579 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 103272401 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BOYD DENISE | Agent | 1010 E. ADAMS STREET, JACKSONVILLE, FL, 32202 |
| Name | Role | Address |
|---|---|---|
| BOYD DENISE R | President | 1010 E. ADAMS STREET, JACKSONVILLE, FL, 32202 |
| Name | Role | Address |
|---|---|---|
| BOYD DENISE R | Treasurer | 1010 E. ADAMS STREET, JACKSONVILLE, FL, 32202 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-04-30 | 1010 E. ADAMS STREET, SUITE 235, JACKSONVILLE, FL 32202 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-04-30 | 1010 E. ADAMS STREET, SUITE 235, JACKSONVILLE, FL 32202 | No data |
| CHANGE OF MAILING ADDRESS | 2016-04-30 | 1010 E. ADAMS STREET, SUITE 235, JACKSONVILLE, FL 32202 | No data |
| REGISTERED AGENT NAME CHANGED | 2016-04-30 | BOYD, DENISE | No data |
| REINSTATEMENT | 2014-10-15 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| LC AMENDMENT | 2014-07-07 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2023-02-21 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-03-17 |
| ANNUAL REPORT | 2020-07-18 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-04-27 |
| ANNUAL REPORT | 2017-08-28 |
| ANNUAL REPORT | 2016-04-30 |
| ANNUAL REPORT | 2015-04-30 |
| REINSTATEMENT | 2014-10-15 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
