| Entity Name: | REVIVE WELLNESS GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 05 Jul 2019 (6 years ago) |
| Document Number: | L19000174383 |
| FEI/EIN Number | 84-2422350 |
| Address: | 2647 Narnia Way, Land O Lakes, FL, 34638, US |
| Mail Address: | 2647 Narnia Way, Land O Lakes, FL, 34638, US |
| ZIP code: | 34638 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154977064 | 2019-08-15 | 2023-06-05 | 2647 NARNIA WAY UNIT 102, LAND O LAKES, FL, 346387270, US | 2647 NARNIA WAY UNIT 102, LAND O LAKES, FL, 346387270, US | |||||||||||||||||||||
|
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| Phone | +1 407-250-7831 |
Authorized person
| Name | MRS. LEIGHYA J RICHARD |
| Role | OWNER/LICENSED PSYCHOTHERAPIST |
| Phone | 4072507831 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QM0855X - Adolescent and Children Mental Health Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| RICHARD LEIGHYA J | Agent | 2647 Narnia Way, Land O Lakes, FL, 34638 |
| Name | Role | Address |
|---|---|---|
| RICHARD LEIGHYA J | Manager | 2647 Narnia Way, Land O Lakes, FL, 34638 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-24 | 2647 Narnia Way, STE 102, Land O Lakes, FL 34638 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-12-27 | 2647 Narnia Way, STE 102, Land O Lakes, FL 34638 | No data |
| CHANGE OF MAILING ADDRESS | 2022-12-27 | 2647 Narnia Way, STE 102, Land O Lakes, FL 34638 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-25 |
| ANNUAL REPORT | 2023-04-24 |
| ANNUAL REPORT | 2022-04-08 |
| ANNUAL REPORT | 2021-03-15 |
| ANNUAL REPORT | 2020-04-25 |
| Florida Limited Liability | 2019-07-05 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
