| Entity Name: | 2110 WEST PALM FACILITY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 21 Jan 2015 (10 years ago) |
| Date of dissolution: | 25 Sep 2020 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 years ago) |
| Document Number: | L15000012128 |
| FEI/EIN Number | 47-2714466 |
| Address: | 2110 N FLORIDA MANGO ROAD, Suite 100, WEST PALM BEACH, FL 33409 |
| Mail Address: | 2110 N FLORIDA MANGO ROAD, 101, WEST PALM BEACH, FL 33409 |
| ZIP code: | 33409 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245615863 | 2015-07-24 | 2016-04-14 | 2110 N FLORIDA MANGO RD, WEST PALM BEACH, FL, 334096492, US | 2110 N FLORIDA MANGO RD, WEST PALM BEACH, FL, 334096492, US | |||||||||||||||||||||||
|
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| Phone | +1 561-404-5871 |
| Fax | 5613186413 |
Authorized person
| Name | LARRY HAWKINS |
| Role | OWNER |
| Phone | 5618324780 |
Taxonomy
| Taxonomy Code | 261QR0405X - Substance Use Disorder Rehabilitation Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| License Number | 10D2032848 |
| State | FL |
| Is Primary | No |
| Name | Role |
|---|---|
| Q HEALTH SERVICES, INC | Agent |
| Name | Role |
|---|---|
| Q HEALTH SERVICES, INC | Managing Member |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000116282 | HOUSING SERVICES CORPORATION | EXPIRED | 2019-10-28 | 2024-12-31 | No data | 950 EVERNIA STREET, WEST PALM BEACH, FL, 33401 |
| G17000089104 | Q HEALTH | EXPIRED | 2017-08-14 | 2022-12-31 | No data | 2110 NORTH FLORIDA MANGO RD, SUITE 100, WEST PALM BEACH, FL, 33409 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-08-14 | 2110 N FLORIDA MANGO ROAD, Suite 100, WEST PALM BEACH, FL 33409 | No data |
| CHANGE OF MAILING ADDRESS | 2018-08-14 | 2110 N FLORIDA MANGO ROAD, Suite 100, WEST PALM BEACH, FL 33409 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-08-14 | 2110 N FLORIDA MANGO ROAD, Suite 101, WEST PALM BEACH, FL 33409 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-04-18 | Q Health Services, Inc. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-08-14 |
| ANNUAL REPORT | 2017-04-18 |
| ANNUAL REPORT | 2016-04-29 |
| Florida Limited Liability | 2015-01-21 |
Date of last update: 20 Feb 2025
Sources: Florida Department of State
