| Entity Name: | BEACHES BEHAVIORAL HEALTH LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 31 Jan 2014 (11 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 09 Apr 2018 (7 years ago) |
| Document Number: | L14000017289 |
| FEI/EIN Number | 364818981 |
| Address: | 3733 UNIVERSITY BLVD W, JACKSONVILLE, FL, 32217, US |
| Mail Address: | 6652 EPPING FOREST WAY N, JACKSONVILLE, FL, 32217, US |
| ZIP code: | 32217 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770955254 | 2015-10-23 | 2021-09-17 | 6652 EPPING FOREST WAY N, JACKSONVILLE, FL, 322172648, US | 3733 UNIVERSITY BLVD W STE 209, JACKSONVILLE, FL, 322172103, US | |||||||||||||||||||||
|
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| Phone | +1 904-280-0790 |
| Fax | 9043959181 |
| Phone | +1 904-543-6055 |
Authorized person
| Name | LISA J ROTELLA |
| Role | OWNER |
| Phone | 6103312645 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | SW13084 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Rotella Lisa J | Agent | 6652 Epping Forest Way N, JACKSONVILLE, FL, 32217 |
| Name | Role | Address |
|---|---|---|
| ROTELLA LISA J | Authorized Member | 6652 EPPING FOREST WAY N, JACKSONVILLE, FL, 32217 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000098192 | PSYCHLIFE | ACTIVE | 2015-09-24 | 2025-12-31 | No data | P.O. BOX 1455, PONTE VEDRA BEACH, FL, 32004 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2022-01-20 | 6652 Epping Forest Way N, JACKSONVILLE, FL 32217 | No data |
| CHANGE OF MAILING ADDRESS | 2021-09-17 | 3733 UNIVERSITY BLVD W, JACKSONVILLE, FL 32217 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-08-16 | 3733 UNIVERSITY BLVD W, JACKSONVILLE, FL 32217 | No data |
| REINSTATEMENT | 2018-04-09 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2015-09-29 | Rotella, Lisa J | No data |
| REINSTATEMENT | 2015-09-29 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-15 |
| ANNUAL REPORT | 2024-01-03 |
| ANNUAL REPORT | 2023-02-02 |
| ANNUAL REPORT | 2022-01-20 |
| ANNUAL REPORT | 2021-01-26 |
| ANNUAL REPORT | 2020-02-25 |
| ANNUAL REPORT | 2019-03-30 |
| REINSTATEMENT | 2018-04-09 |
| REINSTATEMENT | 2015-09-29 |
| Florida Limited Liability | 2014-01-31 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
