| Entity Name: | UNIQUE EXCEPTIONAL SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 20 Jun 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: | L17000133751 |
| FEI/EIN Number | 821904138 |
| Address: | 431 WEST OBISPO AVE, CLEWISTON, FL, 33440, US |
| Mail Address: | P.O.BOX 724, CLEWISTON, FL, 33440, US |
| ZIP code: | 33440 |
| County: | Hendry |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982124020 | 2017-06-20 | 2018-03-17 | PO BOX 724, CLEWISTON, FL, 334400724, US | 431 W OBISPO AVE, CLEWISTON, FL, 334404419, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 404-822-8842 |
Authorized person
| Name | MS. RACHEL M. FULLER |
| Role | CEO/COMMUNITY SERVICE PROVIDER |
| Phone | 4048228842 |
Taxonomy
| Taxonomy Code | 305R00000X - Preferred Provider Organization |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 008996400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FULLER RACHEL M | Agent | 431 WEST OBISPO AVE, CLEWISTON, FL, 33440 |
| Name | Role | Address |
|---|---|---|
| FULLER RACHEL M | Authorized Representative | 431 WEST OBISPO AVE, CLEWISTON, FL, 33440 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-03-14 |
| Florida Limited Liability | 2017-06-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
