| Entity Name: | KETAMINE HEALTH CENTERS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
KETAMINE HEALTH CENTERS, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 31 Mar 2016 (9 years ago) |
| Date of dissolution: | 27 Sep 2024 (7 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (7 months ago) |
| Document Number: | L16000064036 |
| FEI/EIN Number |
812074161
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Mail Address: | 5310 Beethoven St, Los Angeles, CA, 90066, US |
| Address: | 9408 SW 87th Ave, Miami, FL, 33176, US |
| ZIP code: | 33176 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811488554 | 2018-05-29 | 2023-07-31 | 9408 SW 87TH AVE STE 302, MIAMI, FL, 331762416, US | 9408 SW 87TH AVE STE 302, MIAMI, FL, 331762416, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-856-9442 |
Authorized person
| Name | RAUL A CRUZ |
| Role | MEDICAL DIRECTOR |
| Phone | 3058569442 |
Taxonomy
| Taxonomy Code | 261QH0100X - Health Service Clinic/Center |
| License Number | 607228 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1104163294 |
| State | FL |
| Issuer | MEDICAID |
| Number | 1144421454 |
| State | FL |
| Issuer | MEDICAID |
| Number | 187533935 |
| State | FL |
| Issuer | MEDICAID |
| Number | 1194817221 |
| State | FL |
| Name | Role |
|---|---|
| IRWIN NATURALS EMERGENCE, INC. | Auth |
| NORTHWEST REGISTERED AGENT LLC | Agent |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000060581 | ALIVE NUTRITIONAL IV | EXPIRED | 2018-05-19 | 2023-12-31 | - | 1430 S. DIXIE HWY, SUITE 204, CORAL GABLES, FL, 33146 |
| G16000085991 | KHC, LLC | ACTIVE | 2016-08-12 | 2026-12-31 | - | 1 ALHAMBRA PLAZA, SUITE1410, CORAL GABLES, FL, 33134 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | - | - |
| CHANGE OF MAILING ADDRESS | 2023-01-06 | 9408 SW 87th Ave, Suite 302, Miami, FL 33176 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2023-01-06 | 7901 4th St N, SUITE 300, St. Petersburg, FL 33702 | - |
| REGISTERED AGENT NAME CHANGED | 2023-01-06 | Northwest Registered Agent LLC | - |
| CHANGE OF PRINCIPAL ADDRESS | 2022-01-21 | 9408 SW 87th Ave, Suite 302, Miami, FL 33176 | - |
| LC STMNT OF RA/RO CHG | 2016-08-09 | - | - |
| LC AMENDMENT AND NAME CHANGE | 2016-07-19 | KETAMINE HEALTH CENTERS, LLC | - |
| LC DISSOCIATION MEM | 2016-04-18 | - | - |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2023-01-09 |
| ANNUAL REPORT | 2023-01-06 |
| ANNUAL REPORT | 2022-01-21 |
| ANNUAL REPORT | 2021-01-31 |
| ANNUAL REPORT | 2020-03-30 |
| ANNUAL REPORT | 2019-03-30 |
| ANNUAL REPORT | 2018-01-14 |
| ANNUAL REPORT | 2017-02-09 |
| CORLCRACHG | 2016-08-09 |
| LC Amendment and Name Change | 2016-07-19 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
