| Entity Name: | SOUTHEASTERN BEHAVIORAL HEALTH, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 13 Apr 2018 (7 years ago) |
| Document Number: | L18000093300 |
| FEI/EIN Number | 82-5327170 |
| Address: | 3303 Thomasville Rd, Tallahassee, FL, 32308, US |
| Mail Address: | 3303 Thomasville Rd, Tallahassee, FL, 32308, US |
| ZIP code: | 32308 |
| County: | Leon |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1689164790 | 2018-05-14 | 2019-12-28 | 3303 THOMASVILLE RD STE 102, TALLAHASSEE, FL, 323087912, US | 3303 THOMASVILLE RD STE 102, TALLAHASSEE, FL, 323087912, US | |||||||||||||||||||||||||||
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| Phone | +1 850-296-3665 |
| Fax | 8502963665 |
Authorized person
| Name | DR. ANGELA CANTO |
| Role | OWNER/AUTHORIZED REPRESENTATIVE |
| Phone | 8502963665 |
Taxonomy
| Taxonomy Code | 103T00000X - Psychologist |
| License Number | PY10048 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 103TS0200X - School Psychologist |
| License Number | SS1033 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| CANTO ANGELA I | Agent | 3303 Thomasville Rd, Tallahassee, FL, 32308 |
| Name | Role | Address |
|---|---|---|
| CANTO ANGELA I | Authorized Representative | 3303 Thomasville Rd, Tallahassee, FL, 32308 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-02-05 | 3303 Thomasville Rd, Suite 102, Tallahassee, FL 32308 | No data |
| CHANGE OF MAILING ADDRESS | 2020-02-05 | 3303 Thomasville Rd, Suite 102, Tallahassee, FL 32308 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-02-05 | 3303 Thomasville Rd, Suite 102, Tallahassee, FL 32308 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-11 |
| ANNUAL REPORT | 2023-04-24 |
| ANNUAL REPORT | 2022-02-01 |
| ANNUAL REPORT | 2021-03-28 |
| ANNUAL REPORT | 2020-02-05 |
| ANNUAL REPORT | 2019-04-09 |
| Florida Limited Liability | 2018-04-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
