| Entity Name: | ACSI COMMUNITY BEHAVIORAL CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 26 Apr 2017 (8 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 09 Dec 2024 (2 months ago) |
| Document Number: | L17000093177 |
| FEI/EIN Number | 82-1338385 |
| Address: | 6303 B BIRD ROAD, MIAMI, FL 33155 |
| Mail Address: | 6303 B BIRD ROAD, MIAMI, FL 33155 |
| ZIP code: | 33155 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013424266 | 2018-01-09 | 2018-01-09 | 3113 STIRLING RD STE 204, FORT LAUDERDALE, FL, 333126547, US | 3113 STIRLING RD STE 204, FORT LAUDERDALE, FL, 333126547, US | |||||||||||||||||||||||||
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| Phone | +1 954-842-3501 |
| Fax | 9542060906 |
Authorized person
| Name | MS. YANET RODRIGUEZ JIMENEZ |
| Role | CEO |
| Phone | 9548423501 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| License Number | MH8867 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 021204200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MINO, YOVANY | Agent | 6303 B BIRD ROAD, MIAMI, FL 33155 |
| Name | Role | Address |
|---|---|---|
| MINO, YOVANY | Authorized Member | 6303 B BIRD ROAD, MIAMI, FL 33155 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-12-09 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-10-05 | MINO, YOVANY | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-06-02 | 6303 B BIRD ROAD, MIAMI, FL 33155 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-06-02 | 6303 B BIRD ROAD, MIAMI, FL 33155 | No data |
| CHANGE OF MAILING ADDRESS | 2020-06-02 | 6303 B BIRD ROAD, MIAMI, FL 33155 | No data |
| REINSTATEMENT | 2019-09-30 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| LC AMENDMENT AND NAME CHANGE | 2017-05-16 | ACSI COMMUNITY BEHAVIORAL CENTER, LLC | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-12-09 |
| ANNUAL REPORT | 2023-05-01 |
| AMENDED ANNUAL REPORT | 2022-10-05 |
| ANNUAL REPORT | 2022-04-29 |
| AMENDED ANNUAL REPORT | 2021-07-09 |
| ANNUAL REPORT | 2021-04-30 |
| AMENDED ANNUAL REPORT | 2020-06-02 |
| ANNUAL REPORT | 2020-01-08 |
| REINSTATEMENT | 2019-09-30 |
| ANNUAL REPORT | 2018-03-27 |
Date of last update: 19 Jan 2025
Sources: Florida Department of State
