| Entity Name: | A CORE CONNECTION SERVICES AND CONSULTING, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 04 Oct 2018 (6 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 13 Jun 2019 (6 years ago) |
| Document Number: | L18000235072 |
| FEI/EIN Number | 831649574 |
| Address: | 2139 West State Road 434, Suite 102, Longwood, FL, 32779, US |
| Mail Address: | 2139 West State Road 434, Suite 102, Longwood, FL, 32779, US |
| ZIP code: | 32779 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881263010 | 2021-06-22 | 2024-10-14 | 2135 W STATE ROAD 434, LONGWOOD, FL, 327794983, US | 2884 S OSCEOLA AVE, ORLANDO, FL, 328065431, US | |||||||||||||||||||||||||
|
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| Phone | +1 407-789-2673 |
| Fax | 4076122359 |
Authorized person
| Name | KELLY GREENE |
| Role | OWNER |
| Phone | 4076394047 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 101145501 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Greene Kelly | Agent | 2139 West State Road 434, Longwood, FL, 32779 |
| Name | Role | Address |
|---|---|---|
| Cardoza Jessica | Auth | 2139 West State Road 434, Longwood, FL, 32779 |
| Greene Kelly | Auth | 2139 West State Road 434, Longwood, FL, 32779 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-03-04 | 2139 West State Road 434, Suite 102, Longwood, FL 32779 | No data |
| CHANGE OF MAILING ADDRESS | 2022-03-04 | 2139 West State Road 434, Suite 102, Longwood, FL 32779 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-03-04 | 2139 West State Road 434, Suite 102, Longwood, FL 32779 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-01-02 | Greene, Kelly | No data |
| LC AMENDMENT | 2019-06-13 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-12 |
| ANNUAL REPORT | 2023-03-03 |
| ANNUAL REPORT | 2022-03-04 |
| ANNUAL REPORT | 2021-01-27 |
| ANNUAL REPORT | 2020-01-02 |
| LC Amendment | 2019-06-13 |
| ANNUAL REPORT | 2019-04-18 |
| Florida Limited Liability | 2018-10-04 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
