| Entity Name: | CHAMPIONS INTEGRATED BEHAVIORAL HEALTH LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 03 Mar 2017 (8 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | L17000049963 |
| FEI/EIN Number | 81-5473041 |
| Address: | 1920 Verano Drive Suite 201, HAINES CITY, FL 33844 |
| Mail Address: | P O Box 332, HAINES CITY, FL 33844 |
| ZIP code: | 33844 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154835064 | 2017-11-30 | 2018-02-08 | PO BOX 332, HAINES CITY, FL, 338450332, US | 1216 TEMPLE CIR, HAINES CITY, FL, 338446157, US | |||||||||||||
|
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| Phone | +1 863-242-3621 |
Authorized person
| Name | MR. TARVARES JERMAINE DOWNING |
| Role | OWNER |
| Phone | 8632423621 |
Taxonomy
| Taxonomy Code | 261QD1600X - Developmental Disabilities Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DOWNING, TARVARES J | Agent | 1216 TEMPLE CIRCLE, HAINES CITY, FL 33844 |
| Name | Role | Address |
|---|---|---|
| DOWNING, TARVARES J | President | 1216 TEMPLE CIRCLE, HAINES CITY, FL 33844 |
| Name | Role | Address |
|---|---|---|
| Downing , Nicole Latrese | Vice President | 1216 Temple Circle, Haines City, FL 33844 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-05-01 | 1920 Verano Drive Suite 201, HAINES CITY, FL 33844 | No data |
| CHANGE OF MAILING ADDRESS | 2018-05-01 | 1920 Verano Drive Suite 201, HAINES CITY, FL 33844 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-05-01 |
| Florida Limited Liability | 2017-03-03 |
Date of last update: 18 Feb 2025
Sources: Florida Department of State
