| Entity Name: | VIDA BEHAVIORAL HEALTH ASSOCIATES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
VIDA BEHAVIORAL HEALTH ASSOCIATES 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: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 26 May 2016 (9 years ago) |
| Document Number: | L16000103663 |
| FEI/EIN Number |
38-4006278
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Mail Address: | 3307 Northlake Blvd, Palm Beach Gardens, FL, 33403, US |
| Address: | 3307 NORTHLAKE BLVD, PALM BEACH GARDENS, FL, 33403, US |
| ZIP code: | 33403 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861991481 | 2018-02-09 | 2022-11-18 | 3307 NORTHLAKE BLVD STE B104, PALM BEACH GARDENS, FL, 334031703, US | 3307 NORTHLAKE BLVD STE B104, PALM BEACH GARDENS, FL, 334031703, US | |||||||||||||||||||||||||||||
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| Phone | +1 401-862-7292 |
| Phone | +1 561-618-5072 |
Authorized person
| Name | MS. SUSSI PEREZ |
| Role | LICENSED MENTAL HEALTH COUNSELOR |
| Phone | 4018627292 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | MH13781 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | ATN693995 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PEREZ TREVINO SUSSI | Manager | 3307 NORTHLAKE BLVD, PALM BEACH GARDENS, FL, 33403 |
| PEREZ TREVINO SUSSI | Agent | 3307 NORTHLAKE BLVD, Palm Beach Gardens, FL, 33403 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000057110 | VIDA HEALTH | ACTIVE | 2024-04-30 | 2029-12-31 | - | 3307 NORTHLAKE BLVD, SUITE B104, PALM BEACH GARDENS, FL, 33403 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-04-30 | 3307 NORTHLAKE BLVD, SUITE B104, PALM BEACH GARDENS, FL 33403 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-30 | 3307 NORTHLAKE BLVD, B104, Palm Beach Gardens, FL 33403 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2020-05-19 | 3307 NORTHLAKE BLVD, SUITE B104, PALM BEACH GARDENS, FL 33403 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-20 |
| ANNUAL REPORT | 2022-04-25 |
| ANNUAL REPORT | 2021-04-02 |
| ANNUAL REPORT | 2020-05-19 |
| ANNUAL REPORT | 2019-04-25 |
| ANNUAL REPORT | 2018-05-01 |
| ANNUAL REPORT | 2017-04-10 |
| Florida Limited Liability | 2016-05-26 |
Date of last update: 01 Mar 2025
Sources: Florida Department of State
