| Entity Name: | INNER AWAKENING THERAPY CENTER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
INNER AWAKENING THERAPY CENTER 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: | 13 Mar 2017 (8 years ago) |
| Document Number: | L17000056797 |
| FEI/EIN Number |
82-0875597
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 69 Spring Lake Drive, DeBary, FL, 32713, US |
| Mail Address: | 69 Spring Lake Drive, DeBary, FL, 32713, US |
| ZIP code: | 32713 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205325297 | 2018-05-04 | 2021-10-04 | 1575 DETRICK AVE, DELAND, FL, 327242042, US | 1575 DETRICK AVE, DELAND, FL, 327242042, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 407-906-8633 |
Authorized person
| Name | ADEL M CEBALLOS-ROSARIO |
| Role | OWNER |
| Phone | 4079068633 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | MH14780 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1205325297 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| RALPH F GARCIA, PLLC | Agent | - |
| CEBALLOS-ROSARIO ADEL M | Manager | 69 Spring Lake Drive, DeBary, FL, 32713 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-26 | 69 Spring Lake Drive, DeBary, FL 32713 | - |
| CHANGE OF MAILING ADDRESS | 2024-03-26 | 69 Spring Lake Drive, DeBary, FL 32713 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-26 | 69 Spring Lake Drive, DeBary, FL 32713 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-26 |
| ANNUAL REPORT | 2023-01-18 |
| ANNUAL REPORT | 2022-04-01 |
| ANNUAL REPORT | 2021-01-31 |
| ANNUAL REPORT | 2020-01-20 |
| AMENDED ANNUAL REPORT | 2019-07-31 |
| ANNUAL REPORT | 2019-04-14 |
| ANNUAL REPORT | 2018-03-06 |
| Florida Limited Liability | 2017-03-13 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
