| Entity Name: | KIMBALL CLINICAL SOLUTIONS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 29 May 2014 (11 years ago) |
| Document Number: | L14000086502 |
| FEI/EIN Number | 47-0967880 |
| Address: | 5729 16th Ave N, St Petersburg, FL, 33710, US |
| Mail Address: | 5729 16th Ave N, St Petersburg, FL, 33710, US |
| ZIP code: | 33710 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750795944 | 2014-06-16 | 2014-06-16 | 3323 W IVY ST, TAMPA, FL, 336071524, US | 324 W BEARSS AVE, SUITE B, TAMPA, FL, 336131228, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 813-766-3100 |
| Phone | +1 888-899-7736 |
Authorized person
| Name | ALISON KIMBALL |
| Role | OWNER |
| Phone | 8138030879 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | SW10074 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 004066100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KIMBALL ALISON | Agent | 5729 16th Ave N, St Petersburg, FL, 33710 |
| Name | Role | Address |
|---|---|---|
| KIMBALL ALISON | Manager | 5729 16th Ave N, St Petersburg, FL, 33710 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-29 | 5729 16th Ave N, St Petersburg, FL 33710 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-29 | 5729 16th Ave N, St Petersburg, FL 33710 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-29 | 5729 16th Ave N, St Petersburg, FL 33710 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-29 |
| ANNUAL REPORT | 2022-04-30 |
| ANNUAL REPORT | 2021-05-01 |
| ANNUAL REPORT | 2020-06-26 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-04-22 |
| ANNUAL REPORT | 2016-04-29 |
| ANNUAL REPORT | 2015-03-28 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
