| Entity Name: | AMERICAN HEALTHCARE COMMUNITY BEHAVIORAL SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 18 Mar 2016 (9 years ago) |
| Last Event: | LC NAME CHANGE |
| Event Date Filed: | 31 Jan 2024 (a year ago) |
| Document Number: | L16000056184 |
| FEI/EIN Number | 81-1940778 |
| Address: | 303 Commerce Center Dr., SAINT CLOUD, FL, 34769, US |
| Mail Address: | 303 Commerce Center Dr., SAINT CLOUD, FL, 34769, US |
| ZIP code: | 34769 |
| County: | Osceola |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710332671 | 2016-04-28 | 2017-12-27 | 1203 FLORIDA AVE., ST. CLOUD, FL, 34769, US | 1203 FLORIDA AVE., ST. CLOUD, FL, 34769, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 407-593-1062 |
| Fax | 4072777622 |
Authorized person
| Name | MR. DALE A. ZIGLEAR |
| Role | OWNER/CEO |
| Phone | 3212284134 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | MT2452 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | No |
| Taxonomy Code | 106H00000X - Marriage & Family Therapist |
| License Number | CCMS100378-AC |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 015614700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Ziglear Dale | Agent | 303 Commerce Center Dr., SAINT CLOUD, FL, 34769 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000038475 | A HELPING HAND COUNSELING CENTER | ACTIVE | 2017-04-10 | 2027-12-31 | No data | 303 COMMERCE CENTER DR., SAINT CLOUD, FL, 34769 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC NAME CHANGE | 2024-01-31 | AMERICAN HEALTHCARE COMMUNITY BEHAVIORAL SERVICES LLC | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-05-27 | 303 Commerce Center Dr., SAINT CLOUD, FL 34769 | No data |
| CHANGE OF MAILING ADDRESS | 2020-05-27 | 303 Commerce Center Dr., SAINT CLOUD, FL 34769 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-05-27 | 303 Commerce Center Dr., SAINT CLOUD, FL 34769 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-02-14 | Ziglear, Dale | No data |
| LC AMENDMENT | 2016-06-01 | No data | No data |
| Name | Date |
|---|---|
| LC Name Change | 2024-01-31 |
| ANNUAL REPORT | 2024-01-27 |
| ANNUAL REPORT | 2023-01-27 |
| ANNUAL REPORT | 2022-03-17 |
| ANNUAL REPORT | 2021-02-23 |
| ANNUAL REPORT | 2020-05-27 |
| ANNUAL REPORT | 2019-04-08 |
| ANNUAL REPORT | 2018-04-20 |
| ANNUAL REPORT | 2017-02-14 |
| LC Amendment | 2016-06-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
