| Entity Name: | REVIVE DETOX CENTER, LLC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 24 Feb 2014 (11 years ago) |
| Date of dissolution: | 02 Feb 2019 (6 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 02 Feb 2019 (6 years ago) |
| Document Number: | L14000030824 |
| FEI/EIN Number | 46-4894660 |
| Address: | 10570 South US Highway 1, Suite 102, PORT SAINT LUCIE, FL 34952 |
| Mail Address: | 340 SW Quiet Woods, PORT SAINT LUCIE, FL 34953 |
| ZIP code: | 34952 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003231820 | 2014-03-03 | 2014-03-07 | 344 SW QUIET WOODS, PORT SAINT LUCIE, FL, 349538230, US | 8489 S FEDERAL HWY # 1, (S. FEDERAL HIGHWAY) STE.16, PORT SAINT LUCIE, FL, 349523360, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 772-828-6992 |
Authorized person
| Name | MR. RAFAEL A. HERNANDEZ JR. |
| Role | OWNER |
| Phone | 7728286992 |
Taxonomy
| Taxonomy Code | 324500000X - Substance Abuse Rehabilitation Facility |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| REVIVE DETOX CENTER LLC | 2018 | 464894600 | 2019-01-23 | REVIVE DETOX CENTER LLC | 33 | |||||||||||||||||||||||
|
||||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2019-01-23 |
| Name of individual signing | BETH HERNANDEZ |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2014-10-01 |
| Business code | 621420 |
| Sponsor’s telephone number | 7728002100 |
| Plan sponsor’s address | 10570 SOUTH US HWY 1, SUITE 102, PORT ST.LUCIE, FL, 34952 |
Signature of
| Role | Plan administrator |
| Date | 2018-09-17 |
| Name of individual signing | BETH HERNANDEZ |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ, BETH I | Agent | 340 SW Quiet Woods, PORT SAINT LUCIE, FL 34953 |
| Name | Role | Address |
|---|---|---|
| RAFAEL, HERNANDEZ A, JR | Authorized Member | 340 SW QUIET WOODS, PORT SAINT LUCIE, FL 34953 |
| HERNANDEZ, BETH IRIS | Authorized Member | 340 SW QUIET WOODS, PORT SAINT LUCIE, FL 34953 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000111768 | FLORIDA LIFE RECOVERY | EXPIRED | 2017-10-10 | 2022-12-31 | No data | 10570 SOUTH US HIGHWAY 1, SUITE 102, PORT SAINT LUCIE, FL, 34952 |
| G17000111783 | REVIVE WELLNESS | EXPIRED | 2017-10-10 | 2022-12-31 | No data | 10570 SOUTH US HIGHWAY 1, SUITE 102, PORT SAINT LUCIE, FL, 34952 |
| G15000039351 | FLORIDA LIFE RECOVERY | EXPIRED | 2015-04-20 | 2020-12-31 | No data | 10540-10542 SOUTH US HIGHWAY 1, PORT SAINT LUCIE, FL, 34952 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2019-02-02 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-03-22 | 10570 South US Highway 1, Suite 102, PORT SAINT LUCIE, FL 34952 | No data |
| CHANGE OF MAILING ADDRESS | 2018-03-22 | 10570 South US Highway 1, Suite 102, PORT SAINT LUCIE, FL 34952 | No data |
| LC AMENDMENT | 2017-02-02 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-01-09 | 340 SW Quiet Woods, PORT SAINT LUCIE, FL 34953 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2019-02-02 |
| ANNUAL REPORT | 2018-03-22 |
| LC Amendment | 2017-02-02 |
| ANNUAL REPORT | 2017-01-09 |
| ANNUAL REPORT | 2016-03-29 |
| ANNUAL REPORT | 2015-04-04 |
| Florida Limited Liability | 2014-02-24 |
Date of last update: 22 Jan 2025
Sources: Florida Department of State
