| Entity Name: | BRIDGE TO SHORE RECOVERY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 17 Jan 2014 (11 years ago) |
| Document Number: | L14000009387 |
| FEI/EIN Number | 46-4555080 |
| Address: | 3930 US 1 South, ST AUGUSTINE, FL, 32086, US |
| Mail Address: | 3930 US 1 South, ST AUGUSTINE, FL, 32086, US |
| ZIP code: | 32086 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265004576 | 2021-07-15 | 2024-02-22 | 3930 US 1 S, SAINT AUGUSTINE, FL, 320867089, US | 3 DAVIS ST, SAINT AUGUSTINE, FL, 320840476, US | |||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 904-217-0480 |
| Fax | 9042173081 |
Authorized person
| Name | PHILLIP D SNYDER |
| Role | ADMISSIONS SUPERVISOR |
| Phone | 9042170480 |
Taxonomy
| Taxonomy Code | 261QR0405X - Substance Use Disorder Rehabilitation Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 324500000X - Substance Abuse Rehabilitation Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MD |
| Number | ME38055 |
| State | FL |
| Issuer | LMHC |
| Number | MH17663 |
| State | FL |
| Issuer | LCSW |
| Number | SW16603 |
| State | FL |
| Issuer | APRN |
| Number | APRN2520572 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CHANE JASON E | Agent | 3930 US 1 South, ST AUGUSTINE, FL, 32086 |
| Name | Role | Address |
|---|---|---|
| CHANE JASON E | Manager | 3930 US 1 South, ST AUGUSTINE, FL, 32086 |
| Name | Role | Address |
|---|---|---|
| CHANE LAUREN T | Authorized Member | 3930 US 1 South, ST AUGUSTINE, FL, 32086 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000045827 | THE AUGUSTINE RECOVERY CENTER | EXPIRED | 2014-05-08 | 2024-12-31 | No data | 3930 US 1 SOUTH, SAINT AUGUSTINE, FL, 32086 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2015-04-22 | 3930 US 1 South, ST AUGUSTINE, FL 32086 | No data |
| CHANGE OF MAILING ADDRESS | 2015-04-22 | 3930 US 1 South, ST AUGUSTINE, FL 32086 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-04-22 | 3930 US 1 South, ST AUGUSTINE, FL 32086 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-14 |
| ANNUAL REPORT | 2023-03-02 |
| ANNUAL REPORT | 2022-02-05 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-04-27 |
| ANNUAL REPORT | 2019-04-09 |
| ANNUAL REPORT | 2018-04-12 |
| ANNUAL REPORT | 2017-03-17 |
| ANNUAL REPORT | 2016-05-05 |
| ANNUAL REPORT | 2015-04-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
