| Entity Name: | CAMEN BEHAVIORAL SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 12 Sep 2013 (11 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 22 Aug 2019 (5 years ago) |
| Document Number: | L13000129191 |
| FEI/EIN Number | 46-3632071 |
| Address: | 5959 LAKE ELLENOR DR, ORLANDO, FL, 32809, US |
| Mail Address: | 5959 LAKE ELLENOR DR, ORLANDO, FL, 32809, US |
| ZIP code: | 32809 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1275296097 | 2021-10-19 | 2022-04-07 | 148 WILSHIRE BLVD, CASSELBERRY, FL, 327075372, US | 146 WILSHIRE BLVD, CASSELBERRY, FL, 327075372, US | |||||||||||||||||||||||
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| Phone | +1 321-972-4039 |
| Fax | 3214459760 |
Authorized person
| Name | CLAIRE ALEXIS RICH LOTTMAN |
| Role | CEO |
| Phone | 3219724039 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | Yes |
| Taxonomy Code | 106E00000X - Assistant Behavior Analyst |
| Is Primary | No |
| Taxonomy Code | 106S00000X - Behavior Technician |
| Is Primary | No |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CAMEN BEHAVIORAL SERVICES LLC 401(K) PROFIT SHARING PLAN AND TRUST | 2023 | 463632071 | 2024-07-22 | CAMEN BEHAVIORAL SERVICES, LLC | 128 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-07-22 |
| Name of individual signing | CHRIS HORNE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 812990 |
| Sponsor’s telephone number | 3219724039 |
| Plan sponsor’s address | 148 WILSHIRE BLVD, CASSELBERRY, FL, 32707 |
Signature of
| Role | Plan administrator |
| Date | 2023-10-06 |
| Name of individual signing | CHRIS HORNE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 812990 |
| Sponsor’s telephone number | 3219724039 |
| Plan sponsor’s address | 148 WILSHIRE BLVD, CASSELBERRY, FL, 32707 |
Signature of
| Role | Plan administrator |
| Date | 2022-09-26 |
| Name of individual signing | CHRIS HORNE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 812990 |
| Sponsor’s telephone number | 3219724039 |
| Plan sponsor’s address | 148 WILSHIRE BLVD, CASSELBERRY, FL, 32707 |
Signature of
| Role | Plan administrator |
| Date | 2021-04-02 |
| Name of individual signing | DAVID LOTTMAN |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| LOTTMAN DAVID | Agent | 5959 LAKE ELLENOR DR, ORLANDO, FL, 32809 |
| Name | Role | Address |
|---|---|---|
| LOTTMAN CLAIRE A | Chief Executive Officer | 5959 LAKE ELLENOR DR, ORLANDO, FL, 32809 |
| Name | Role | Address |
|---|---|---|
| LOTTMAN DAVID | Chief Financial Officer | 5959 LAKE ELLENOR DR, ORLANDO, FL, 32809 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000026503 | CAMEN BEHAVIORAL | ACTIVE | 2022-02-11 | 2027-12-31 | No data | 148 WILSHIRE BLVD, CASSELBERRY, FL, 32712 |
| G22000014755 | CAMEN UNIVERSITY | ACTIVE | 2022-02-07 | 2027-12-31 | No data | 148 WILSHIRE BLVD, CASSELBERRY, FL, 32707 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-13 | 5959 LAKE ELLENOR DR, ORLANDO, FL 32809 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-01-23 | 5959 LAKE ELLENOR DR, ORLANDO, FL 32809 | No data |
| CHANGE OF MAILING ADDRESS | 2023-01-23 | 5959 LAKE ELLENOR DR, ORLANDO, FL 32809 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-01-23 | LOTTMAN, DAVID | No data |
| LC AMENDMENT | 2019-08-22 | No data | No data |
| LC AMENDMENT | 2015-09-08 | No data | No data |
| LC AMENDMENT AND NAME CHANGE | 2015-01-27 | CAMEN BEHAVIORAL SERVICES, LLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-13 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-04-20 |
| ANNUAL REPORT | 2021-03-08 |
| ANNUAL REPORT | 2020-05-20 |
| ANNUAL REPORT | 2019-04-23 |
| ANNUAL REPORT | 2018-04-23 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-04-27 |
| LC Amendment | 2015-09-08 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
