| Entity Name: | 1ST CARE CASE MANAGEMENT SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
1ST CARE CASE MANAGEMENT SERVICES 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: | 01 Dec 2017 (7 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 03 Feb 2021 (4 years ago) |
| Document Number: | L17000247136 |
| FEI/EIN Number |
82-3587174
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1400 NW 107 AVENUE #310, MIAMI, FL, 33172 |
| Mail Address: | 1400 NW 107 AVENUE #310, MIAMI, FL, 33172 |
| ZIP code: | 33172 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518472414 | 2017-12-13 | 2024-01-23 | 1400 NW 107TH AVE STE 310, SWEETWATER, FL, 331722746, US | 1400 NW 107TH AVE STE 310, SWEETWATER, FL, 331722746, US | |||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 786-542-5043 |
| Fax | 7865425049 |
Authorized person
| Name | ALEXANDER MATA |
| Role | PRESIDENT |
| Phone | 7865425043 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | No |
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 107235000 |
| State | FL |
| Issuer | MEDICAID |
| Number | 116958500 |
| State | FL |
| Issuer | MEDICAID |
| Number | 023273200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MATA ALEXANDER | Authorized Member | 1400 NW 107 AVENUE #310, MIAMI, FL, 33172 |
| MATA ALEXANDER | Agent | 1400 NW 107 AVENUE #310, MIAMI, FL, 33172 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2021-02-03 | 1400 NW 107 AVENUE #310, MIAMI, FL 33172 | - |
| LC AMENDMENT | 2021-02-03 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2021-02-03 | 1400 NW 107 AVENUE #310, MIAMI, FL 33172 | - |
| CHANGE OF MAILING ADDRESS | 2021-02-03 | 1400 NW 107 AVENUE #310, MIAMI, FL 33172 | - |
| LC AMENDMENT | 2020-03-05 | - | - |
| LC AMENDMENT | 2019-05-23 | - | - |
| REINSTATEMENT | 2018-10-04 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-04 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-03-09 |
| ANNUAL REPORT | 2021-03-05 |
| LC Amendment | 2021-02-03 |
| ANNUAL REPORT | 2020-03-09 |
| LC Amendment | 2020-03-05 |
| LC Amendment | 2019-05-23 |
| ANNUAL REPORT | 2019-02-11 |
| Florida Limited Liability | 2017-12-01 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 9816387203 | 2020-04-28 | 0455 | PPP | 6405 NW 36 St, Virginia Gardens, FL, 33166 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Mar 2025
Sources: Florida Department of State
