| Entity Name: | ALINA COMMUNITY CENTER AT MOUNT DORA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 13 Aug 2018 (6 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 23 Mar 2020 (5 years ago) |
| Document Number: | L18000192892 |
| FEI/EIN Number | 83-1557430 |
| Address: | 4601 North Highway 19A, Mount Dora, FL, 32757, US |
| Mail Address: | 4800 N STATE RD 7, LAUDERDALE LAKSE, FL, 33319, US |
| ZIP code: | 32757 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1841801842 | 2020-08-12 | 2020-08-12 | 4601 N HIGHWAY 19A, MOUNT DORA, FL, 327572039, US | 4601 N HIGHWAY 19A, MOUNT DORA, FL, 327572039, US | |||||||||||||||||||||
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| Phone | +1 352-602-7924 |
| Fax | 3526024952 |
Authorized person
| Name | GRAVIL JOSEPH |
| Role | CEO |
| Phone | 9543923000 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 106393700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| JOSEPH GRAVIL | Agent | 4800 N STATE ROAD 7, LAUDERDALE LAKES, FL, 33319 |
| Name | Role | Address |
|---|---|---|
| JOSEPH GRAVIL | Manager | 4800 N STATE RD 7, LAUDERDALE LAKSE, FL, 33319 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2023-04-27 | 4601 North Highway 19A, Mount Dora, FL 32757 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-27 | 4800 N STATE ROAD 7, F103, LAUDERDALE LAKES, FL 33319 | No data |
| LC AMENDMENT | 2020-03-23 | No data | No data |
| LC NAME CHANGE | 2020-02-26 | ALINA COMMUNITY CENTER AT MOUNT DORA, LLC | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-02-19 | 4601 North Highway 19A, Mount Dora, FL 32757 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-02-19 | JOSEPH, GRAVIL | No data |
| LC AMENDMENT | 2019-01-02 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-04-30 |
| LC Amendment | 2020-03-23 |
| LC Name Change | 2020-02-26 |
| ANNUAL REPORT | 2020-02-19 |
| ANNUAL REPORT | 2019-06-12 |
| LC Amendment | 2019-01-02 |
| Florida Limited Liability | 2018-08-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
