| Entity Name: | CHANGESU LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 13 Mar 2017 (8 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | L17000058154 |
| Address: | 3110 1ST AVE N, UNIT 6, ST PETERSBURG, FL, 33713 |
| Mail Address: | 3110 1ST AVE N, UNIT 6, ST PETERSBURG, FL, 33713 |
| ZIP code: | 33713 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578072039 | 2017-09-27 | 2022-07-21 | 998 EMERSON DR, DUNEDIN, FL, 346986039, US | 998 EMERSON DRIVE, DUNEDIN, FL, 34698, US | |||||||||||||||||||||||||
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| Phone | +1 727-422-5659 |
| Fax | 7272794944 |
Authorized person
| Name | MS. DIANA SAUM HERRING |
| Role | OWNER |
| Phone | 7274225659 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | IMH1215 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1043587959 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HERRING DIANA | Agent | 998 EMERSON DR., DUNEDIN, FL, 34698 |
| Name | Role | Address |
|---|---|---|
| HERRING DIANA | Manager | 998 EMERSON DR., DUNEDIN, FL, 34698 |
| ERA DAWNE | Manager | 1701 GULF WAY, UNIT 1, PASS-A-GRILLE, FL, 33706 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2017-03-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
