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OUTPATIENT HEALTH SERVICES, LLC - Florida Company Profile

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Company Details

Entity Name: OUTPATIENT HEALTH SERVICES, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 13 Sep 2016 (9 years ago)
Last Event: LC AMENDMENT
Event Date Filed: 17 Nov 2016 (9 years ago)
Document Number: L16000171221
FEI/EIN Number 81-3950343
Address: 1405 SE GOLDTREE DRIVE STE D, Port st lucie, FL, 34952, US
Mail Address: 401 Old Dixie Hwy #3539, Jupiter, FL, 33469, US
ZIP code: 34952
City: Port Saint Lucie
County: St. Lucie
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
CT CORPORTATION SYSTEM Agent 1200 S PINE ISLAND ROAD, PLANTATION, FL, 33324
PHOENIX BEHAVIORAL HEALTHCARE, LLC Manager 318 US-1, Jupiter, FL, 33477

National Provider Identifier

NPI Number:
1356884712
Certification Date:
2025-05-13

Authorized Person:

Name:
MR. JENNIFER SLIS
Role:
RCM MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
103TA0400X - Addiction (Substance Use Disorder) Psychologist
Is Primary:
No
Selected Taxonomy:
207QA0401X - Addiction Medicine (Family Medicine) Physician
Is Primary:
Yes

Contacts:

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2025-01-30 1405 SE GOLDTREE DRIVE STE D, Port st lucie, FL 34952 -
CHANGE OF PRINCIPAL ADDRESS 2024-10-25 1405 SE GOLDTREE DRIVE STE D, Port st lucie, FL 34952 -
CHANGE OF MAILING ADDRESS 2024-10-25 1405 SE GOLDTREE DRIVE STE D, Port st lucie, FL 34952 -
REGISTERED AGENT NAME CHANGED 2024-10-25 CT CORPORTATION SYSTEM -
REGISTERED AGENT ADDRESS CHANGED 2024-10-25 1200 S PINE ISLAND ROAD, #250, PLANTATION, FL 33324 -
LC AMENDMENT 2016-11-17 - -

Documents

Name Date
ANNUAL REPORT 2025-01-30
AMENDED ANNUAL REPORT 2024-10-25
ANNUAL REPORT 2024-05-01
ANNUAL REPORT 2023-04-30
ANNUAL REPORT 2022-04-30
ANNUAL REPORT 2021-04-08
ANNUAL REPORT 2020-06-21
ANNUAL REPORT 2019-04-24
ANNUAL REPORT 2018-04-18
ANNUAL REPORT 2017-02-02

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Date of last update: 01 Aug 2025

Sources: Florida Department of State