| Entity Name: | PARADISE BEHAVIORAL HEALTH, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 15 Feb 2017 (8 years ago) |
| Last Event: | LC AMENDMENT AND NAME CHANGE |
| Event Date Filed: | 05 Apr 2017 (8 years ago) |
| Document Number: | L17000036279 |
| FEI/EIN Number | 81-4875477 |
| Address: | 25097 E OLYMPIA AVE, STE 201, Punta Gorda, FL 33950 |
| Mail Address: | 25097 E OLYMPIA AVE, STE 201, Punta Gorda, FL 33950 |
| ZIP code: | 33950 |
| County: | Charlotte |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215462288 | 2017-04-26 | 2024-01-25 | 25097 OLYMPIA AVE STE 201, PUNTA GORDA, FL, 339503914, US | 25097 OLYMPIA AVE STE 201, PUNTA GORDA, FL, 339503914, US | |||||||||||||||||||||||||
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| Phone | +1 941-347-8341 |
| Fax | 9413477702 |
Authorized person
| Name | MIZYL F DAMAYO |
| Role | OWNER |
| Phone | 9413478341 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | ME114111 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 103283300 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PARADISE BEHAVIORAL HEALTH LLC 401(K) PROFIT SHARING PLAN & TRUST | 2023 | 814875477 | 2024-07-19 | PARADISE BEHAVIORAL HEALTH LLC | 11 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-07-19 |
| Name of individual signing | EDWARD ROJAS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621399 |
| Sponsor’s telephone number | 4025255100 |
| Plan sponsor’s address | 25097 E OLYMPIA AVE, SUITE 201, PUNTA GORDA, FL, 33950 |
Signature of
| Role | Plan administrator |
| Date | 2023-04-11 |
| Name of individual signing | MIZYL DAMAYO |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621399 |
| Sponsor’s telephone number | 4025255100 |
| Plan sponsor’s address | 25097 E OLYMPIA AVE, SUITE 205, PUNTA GORDA, FL, 33950 |
Signature of
| Role | Plan administrator |
| Date | 2022-06-15 |
| Name of individual signing | EDWARD ROJAS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621399 |
| Sponsor’s telephone number | 4025255100 |
| Plan sponsor’s address | 25097 E OLYMPIA AVE, SUITE 205, PUNTA GORDA, FL, 33950 |
Signature of
| Role | Plan administrator |
| Date | 2021-05-10 |
| Name of individual signing | MIZYL DAMAYO |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| DAMAYO-STINSON, MIZYL | Agent | 25097 E OLYMPIA AVE, STE 201, Punta Gorda, FL 33950 |
| Name | Role | Address |
|---|---|---|
| DAMAYO, MIZYL | Medical Director | 25097 E OLYMPIA AVE, STE 201 Punta Gorda, FL 33950 |
| Name | Role | Address |
|---|---|---|
| Damayo, Mike | Practice Manager | 25097 E OLYMPIA AVE, STE 201 Punta Gorda, FL 33950 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-10 | 25097 E OLYMPIA AVE, STE 201, Punta Gorda, FL 33950 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-10 | 25097 E OLYMPIA AVE, STE 201, Punta Gorda, FL 33950 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-10 | 25097 E OLYMPIA AVE, STE 201, Punta Gorda, FL 33950 | No data |
| LC AMENDMENT AND NAME CHANGE | 2017-04-05 | PARADISE BEHAVIORAL HEALTH, LLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-10 |
| ANNUAL REPORT | 2024-01-30 |
| AMENDED ANNUAL REPORT | 2023-04-10 |
| ANNUAL REPORT | 2023-01-14 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-02-05 |
| ANNUAL REPORT | 2020-03-20 |
| ANNUAL REPORT | 2019-03-11 |
| ANNUAL REPORT | 2018-02-02 |
| LC Amendment and Name Change | 2017-04-05 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2073707700 | 2020-05-01 | 0455 | PPP | 201 W MARION AVE UNIT 1209, PUNTA GORDA, FL, 33950 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 18 Feb 2025
Sources: Florida Department of State
