| Entity Name: | CENTER OF AGAPE CHRISTIAN COUNSELING, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 29 Oct 2014 (10 years ago) |
| Document Number: | L14000168820 |
| FEI/EIN Number | 47-2200513 |
| Address: | 4907 VAN DYKE ROAD, LUTZ, FL, 33558 |
| Mail Address: | 4907 VAN DYKE ROAD, LUTZ, FL, 33558 |
| ZIP code: | 33558 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184091183 | 2015-08-25 | 2015-08-25 | 4907 VAN DYKE RD, LUTZ, FL, 335584813, US | 4907 VAN DYKE RD, LUTZ, FL, 335584813, US | |||||||||||||||||||||||||||||||
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| Phone | +1 813-962-1018 |
| Fax | 8132653966 |
Authorized person
| Name | MILDRED W PHILLIPS |
| Role | OWNER |
| Phone | 8139621018 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | SW1370 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 002809400 |
| State | FL |
| Issuer | MEDICARE |
| Number | BL767A |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PHILLIPS MILDRED | Agent | 4020 ARROYO LANE, TAMPA, FL, 33624 |
| Name | Role | Address |
|---|---|---|
| PHILLIPS MILDRED | Manager | 4907 VAN DYKE ROAD, LUTZ, FL, 33558 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| ANNUAL REPORT | 2023-04-26 |
| ANNUAL REPORT | 2022-04-08 |
| ANNUAL REPORT | 2021-03-26 |
| ANNUAL REPORT | 2020-06-08 |
| ANNUAL REPORT | 2019-05-06 |
| ANNUAL REPORT | 2018-04-27 |
| ANNUAL REPORT | 2017-04-24 |
| ANNUAL REPORT | 2016-04-28 |
| ANNUAL REPORT | 2015-04-21 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
