| Entity Name: | WAVES BEHAVIORAL SOLUTIONS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 29 Jan 2018 (7 years ago) |
| Document Number: | L18000024775 |
| FEI/EIN Number | 824200372 |
| Address: | 1260 West Bay Dr. Ste B, Largo, FL, 33770, US |
| Mail Address: | PO Box 7606, CLEARWATER, FL, 33758, US |
| ZIP code: | 33770 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598254179 | 2018-05-09 | 2024-08-12 | PO BOX 7606, CLEARWATER, FL, 337587606, US | 1260 W BAY DR STE B, LARGO, FL, 337702249, US | |||||||||||||||||||||||||
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| Phone | +1 727-641-0218 |
Authorized person
| Name | MRS. KRISTINA ASHLEE BEWLEY |
| Role | OWNER/BCBA |
| Phone | 7273482532 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 101881900 |
| State | FL |
| Issuer | MEDICAID |
| Number | 019719700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BEWLEY KRISTINA A | Agent | 1260 West Bay Dr. Ste B, Largo, FL, 33770 |
| Name | Role | Address |
|---|---|---|
| BEWLEY KRISTINA A | Manager | 1660 IDLE DR., CLEARWATER, FL, 33756 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-01-31 | 1260 West Bay Dr. Ste B, Largo, FL 33770 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-08-16 | 1260 West Bay Dr. Ste B, Largo, FL 33770 | No data |
| CHANGE OF MAILING ADDRESS | 2019-01-11 | 1260 West Bay Dr. Ste B, Largo, FL 33770 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-31 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-02-02 |
| ANNUAL REPORT | 2021-03-17 |
| ANNUAL REPORT | 2020-02-04 |
| ANNUAL REPORT | 2019-01-11 |
| Florida Limited Liability | 2018-01-29 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
