| Entity Name: | BLESSED LEGACY. LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 05 Dec 2017 (7 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 05 Mar 2018 (7 years ago) |
| Document Number: | L17000249052 |
| FEI/EIN Number | 82-3609776 |
| Address: | 5602 Gateway Drive, Tampa, FL, 33615, US |
| Mail Address: | 5602 Gateway Drive, Tampa, FL, 33615, US |
| ZIP code: | 33615 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073193991 | 2021-04-13 | 2024-11-10 | 4302 GULFWINDS DR, LUTZ, FL, 335582744, US | 5602 GATEWAY DR, TAMPA, FL, 336154123, US | |||||||||||||||||||||||||||||
|
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| Phone | +1 954-638-3770 |
Authorized person
| Name | YADIRA SUAREZ-PITA |
| Role | OWNER |
| Phone | 9546383770 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | No |
| Taxonomy Code | 261QM0855X - Adolescent and Children Mental Health Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 15908 |
| State | FL |
| Issuer | MEDICAID |
| Number | 106091700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Suarez Pita Yadira Mrs. | Agent | 4302 Gulfwinds Dr, Lutz, FL, 33558 |
| Name | Role | Address |
|---|---|---|
| Suarez Pita Yadira | President | 4302 Gulfwinds Dr, Lutz, FL, 33558 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000161427 | LIFE SKILLS ACADEMY | ACTIVE | 2020-12-20 | 2025-12-31 | No data | 5602 GATEWAY DR, TAMPA, FL, 33615 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-01-25 | 5602 Gateway Drive, Tampa, FL 33615 | No data |
| CHANGE OF MAILING ADDRESS | 2024-01-25 | 5602 Gateway Drive, Tampa, FL 33615 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-11 | 4302 Gulfwinds Dr, Lutz, FL 33558 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-01-22 | Suarez Pita, Yadira, Mrs. | No data |
| LC AMENDMENT | 2018-03-05 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-25 |
| AMENDED ANNUAL REPORT | 2023-03-11 |
| ANNUAL REPORT | 2023-01-22 |
| ANNUAL REPORT | 2022-02-27 |
| ANNUAL REPORT | 2021-04-09 |
| ANNUAL REPORT | 2020-04-15 |
| ANNUAL REPORT | 2019-09-03 |
| ANNUAL REPORT | 2018-04-18 |
| LC Amendment | 2018-03-05 |
| Florida Limited Liability | 2017-12-05 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
