| Entity Name: | OUTBOUND THERAPY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 10 Apr 2015 (10 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | L15000063671 |
| Address: | 7154 N. UNIVERSITY DRIVE, SUITE 164, TAMARAC, FL, 33321, US |
| Mail Address: | 7154 N. UNIVERSITY DRIVE, SUITE 164, TAMARAC, FL, 33321, US |
| ZIP code: | 33321 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558748913 | 2015-05-05 | 2015-05-05 | 7154 N UNIVERSITY DR, SUITE 164, TAMARAC, FL, 333212916, US | 7154 N UNIVERSITY DR, SUITE 164, TAMARAC, FL, 333212916, US | |||||||||||||||||||||||
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| Fax | 7542030224 |
Authorized person
| Name | KIMBALIE COMMISSIONG |
| Role | OWNER |
| Phone | 9546871288 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | SW7375 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 767061300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| COMMISSIONG KIMBALIE | Agent | 9295 CHAMBERS STREET, TAMARAC, FL, 33321 |
| Name | Role | Address |
|---|---|---|
| COMMISSIONG KIMBALIE | Authorized Representative | 9295 CHAMBERS STREET, TAMARAC, FL, 33321 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2015-04-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
