| Entity Name: | FIRST COAST AUTISM, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 24 Oct 2013 (11 years ago) |
| Last Event: | LC NAME CHANGE |
| Event Date Filed: | 27 Aug 2018 (6 years ago) |
| Document Number: | L13000149871 |
| FEI/EIN Number | 46-3953319 |
| Address: | 8 WILDWOOD LANE, PALM COAST, FL 32137 |
| Mail Address: | 8 WILDWOOD LANE, PALM COAST, FL 32137 |
| ZIP code: | 32137 |
| County: | Flagler |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861821084 | 2013-11-07 | 2019-01-31 | 8 WILDWOOD LANE, PALM COAST, FL, 32137, US | 8 WILDWOOD LANE, PALM COAST, FL, 32137, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 386-227-6485 |
| Fax | 8662471790 |
Authorized person
| Name | MR. DAVID KEITH CALABRESE |
| Role | BEHAVIOR ANALYST/PRESIDENT |
| Phone | 3862276485 |
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 |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| License Number | 1-12-11985 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 021072800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CALABRESE, DAVID K | Agent | 8 WILDWOOD LANE, PALM COAST, FL 32137 |
| Name | Role | Address |
|---|---|---|
| CALABRESE, DAVID K | Managing Member | 8 WILDWOOD LANE, PALM COAST, FL 32137 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000019838 | FLORIDA BEHAVIOR CONSULTANTS | EXPIRED | 2017-02-23 | 2022-12-31 | No data | 8 WILDWOOD LANE, PALM COAST, FL, 32137 |
| G15000081789 | FIRST COAST AUTISM SUPPORTS | ACTIVE | 2015-08-07 | 2025-12-31 | No data | 8 WILDWOOD LANE, PALM COAST, FL, 32137 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC NAME CHANGE | 2018-08-27 | FIRST COAST AUTISM, LLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-01-13 | 8 WILDWOOD LANE, PALM COAST, FL 32137 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-09-24 | 8 WILDWOOD LANE, PALM COAST, FL 32137 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| ANNUAL REPORT | 2023-02-28 |
| ANNUAL REPORT | 2022-04-08 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-06-05 |
| ANNUAL REPORT | 2019-02-28 |
| LC Name Change | 2018-08-27 |
| ANNUAL REPORT | 2018-01-13 |
| ANNUAL REPORT | 2017-01-18 |
| ANNUAL REPORT | 2016-03-03 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 6734407700 | 2020-05-01 | 0491 | PPP | 8 WILDWOOD LN, PALM COAST, FL, 32137-3221 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 21 Feb 2025
Sources: Florida Department of State
