| Entity Name: | INTENSIVE BEHAVIOR SUPPORTS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 10 Feb 2014 (11 years ago) |
| Document Number: | L14000022783 |
| FEI/EIN Number | 46-4777588 |
| Address: | 2251 HARBOR POINTE PLACE, PALM HARBOR, FL, 34683, US |
| Mail Address: | 2251 HARBOR POINTE PLACE, PALM HARBOR, FL, 34683, US |
| ZIP code: | 34683 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073960993 | 2016-05-20 | 2016-05-20 | 90 CITRUS CT, PALM HARBOR, FL, 346833702, US | 90 CITRUS CT, PALM HARBOR, FL, 346833702, US | |||||||||||||||||||||||
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| Phone | +1 727-744-9829 |
Authorized person
| Name | TAMARA NENNI |
| Role | OWNER |
| Phone | 7277449829 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| License Number | 1000169 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID WAIVER |
| Number | 011132200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| NENNI TAMARA M | Agent | 2251 HARBOR POINTE PLACE, PALM HARBOR, FL, 34683 |
| Name | Role | Address |
|---|---|---|
| NENNI TAMARA M | Manager | 2251 HARBOR POINTE PLACE, PALM HARBOR, FL, 34683 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2021-01-31 | 2251 HARBOR POINTE PLACE, PALM HARBOR, FL 34683 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-10-15 | 2251 HARBOR POINTE PLACE, PALM HARBOR, FL 34683 | No data |
| CHANGE OF MAILING ADDRESS | 2020-10-15 | 2251 HARBOR POINTE PLACE, PALM HARBOR, FL 34683 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-11 |
| ANNUAL REPORT | 2023-02-05 |
| ANNUAL REPORT | 2022-03-11 |
| ANNUAL REPORT | 2021-01-31 |
| ANNUAL REPORT | 2020-03-13 |
| ANNUAL REPORT | 2019-03-30 |
| ANNUAL REPORT | 2018-04-07 |
| ANNUAL REPORT | 2017-01-08 |
| ANNUAL REPORT | 2016-04-25 |
| ANNUAL REPORT | 2015-02-06 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5749437707 | 2020-05-01 | 0455 | PPP | 90 CITRUS CT, PALM HARBOR, FL, 34683-3702 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Feb 2025
Sources: Florida Department of State
