| Entity Name: | WILLOW HARBOR THERAPY CENTER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 Aug 2017 (7 years ago) |
| Document Number: | L17000178807 |
| FEI/EIN Number | 82-2547278 |
| Address: | 1010 N 12TH AVE STE 321, PENSACOLA, FL, 32501, US |
| Mail Address: | 9133 BRIGHT LN, POWELL, TN, 37849, US |
| ZIP code: | 32501 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295244127 | 2017-09-22 | 2022-07-21 | 1010 N 12TH AVE STE 321, PENSACOLA, FL, 325013370, US | 1010 N 12TH AVE STE 321, PENSACOLA, FL, 325013370, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 850-776-6297 |
Authorized person
| Name | DR. SABRINA IRENE CONKLIN |
| Role | CEO/OWNER |
| Phone | 8507766297 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | SW12317 |
| State | FL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| DURST JORDAN, CPA, PA | Agent |
| Name | Role | Address |
|---|---|---|
| CONKLIN SABRINA | Managing Member | 9133 BRIGHT LN, POWELL, TN, 37849 |
| CONKLIN LYLE | Managing Member | 9133 BRIGHT LN, POWELL, TN, 37849 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2023-04-05 | 1010 N 12TH AVE STE 321, PENSACOLA, FL 32501 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-22 |
| ANNUAL REPORT | 2023-04-05 |
| ANNUAL REPORT | 2022-03-11 |
| ANNUAL REPORT | 2021-04-26 |
| ANNUAL REPORT | 2020-05-11 |
| ANNUAL REPORT | 2019-04-17 |
| ANNUAL REPORT | 2018-05-01 |
| Florida Limited Liability | 2017-08-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
