| Entity Name: | CREATING A DIFFERENCE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 18 Dec 2017 (7 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 08 Jan 2019 (6 years ago) |
| Document Number: | L17000257592 |
| FEI/EIN Number | 82-3752225 |
| Address: | 800 CYPRESS BLVD, STE 204, POMPANO BEACH, FL, 33069, US |
| Mail Address: | 800 Cypress Blvd, POMPANO BEACH, FL, 33069, US |
| ZIP code: | 33069 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104332394 | 2017-12-26 | 2017-12-27 | 43 S POWERLINE RD # 248, POMPANO BEACH, FL, 330693001, US | 800 CYPRESS BLVD APT 204, POMPANO BEACH, FL, 330694078, US | |||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 786-301-7622 |
Authorized person
| Name | DIANA BENCID |
| Role | SOLE MEMBER |
| Phone | 7863017622 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| License Number | 1-17-27747 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | Yes |
| Taxonomy Code | 261QD1600X - Developmental Disabilities Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QM0855X - Adolescent and Children Mental Health Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | CERTIFICATION NUMBER FOR BCBA |
| Number | 1-17-27747 |
| State | FL |
| Issuer | MEDICAID |
| Number | 019640300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BENCID GONZALEZ DIANA C | Agent | 800 CYPRESS BLVD, POMPANO BEACH, FL, 33069 |
| Name | Role | Address |
|---|---|---|
| BENCID GONZALEZ DIANA C | Managing Member | 800 CYPRESS BLVD STE 204, POMPANO BEACH, FL, 33069 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-03-31 | 800 CYPRESS BLVD, STE 204, POMPANO BEACH, FL 33069 | No data |
| CHANGE OF MAILING ADDRESS | 2023-03-31 | 800 CYPRESS BLVD, STE 204, POMPANO BEACH, FL 33069 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-31 | 800 CYPRESS BLVD, STE 204, POMPANO BEACH, FL 33069 | No data |
| REGISTERED AGENT NAME CHANGED | 2019-02-26 | BENCID GONZALEZ, DIANA C | No data |
| REINSTATEMENT | 2019-01-08 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| ANNUAL REPORT | 2023-03-31 |
| ANNUAL REPORT | 2022-01-25 |
| ANNUAL REPORT | 2021-04-15 |
| ANNUAL REPORT | 2020-02-10 |
| AMENDED ANNUAL REPORT | 2019-02-26 |
| REINSTATEMENT | 2019-01-08 |
| Florida Limited Liability | 2017-12-18 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
