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FOUNDATIONS WELLNESS CENTER, LLC

Company Details

Entity Name: FOUNDATIONS WELLNESS CENTER, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Company
Status: Active
Date Filed: 18 Nov 2015 (9 years ago)
Last Event: LC AMENDMENT
Event Date Filed: 16 May 2016 (9 years ago)
Document Number: L15000195209
FEI/EIN Number 47-5616667
Address: 160 NW CENTRAL PARK PLAZA, UNIT 110, PORT ST. LUCIE, FL 34986
Mail Address: 160 NW CENTRAL PARK PLAZA, UNIT 110, PORT ST. LUCIE, FL 34986
ZIP code: 34986
County: St. Lucie
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1194188656 2016-04-01 2022-07-21 160 NW CENTRAL PARK PLZ STE 110, PORT ST LUCIE, FL, 349861825, US 160 NW CENTRAL PARK PLZ STE 110, PORT ST LUCIE, FL, 349861825, US

Contacts

Phone +1 772-812-6852

Authorized person

Name TRAVIS THAMES
Role CEO
Phone 7723616778

Taxonomy

Taxonomy Code 324500000X - Substance Abuse Rehabilitation Facility
License Number 5601
State FL
Is Primary Yes

Agent

Name Role Address
Flynn, Lisa M Agent 160 NW Central Park Plaza, 110, Port Saint Lucie, FL 34986

Manager

Name Role
TABL HOLDINGS, LLC Manager

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2021-03-09 Flynn, Lisa M No data
CHANGE OF PRINCIPAL ADDRESS 2017-04-13 160 NW CENTRAL PARK PLAZA, UNIT 110, PORT ST. LUCIE, FL 34986 No data
REGISTERED AGENT ADDRESS CHANGED 2017-04-13 160 NW Central Park Plaza, 110, Port Saint Lucie, FL 34986 No data
CHANGE OF MAILING ADDRESS 2016-07-07 160 NW CENTRAL PARK PLAZA, UNIT 110, PORT ST. LUCIE, FL 34986 No data
LC AMENDMENT 2016-05-16 No data No data

Documents

Name Date
ANNUAL REPORT 2024-03-04
ANNUAL REPORT 2023-01-03
ANNUAL REPORT 2022-03-09
ANNUAL REPORT 2021-03-09
ANNUAL REPORT 2020-06-04
ANNUAL REPORT 2019-01-25
ANNUAL REPORT 2018-05-01
ANNUAL REPORT 2017-04-13
ANNUAL REPORT 2016-07-07
LC Amendment 2016-05-16

Date of last update: 20 Jan 2025

Sources: Florida Department of State