| Entity Name: | MELLOW JAC LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 19 Aug 2019 (5 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | L19000210734 |
| FEI/EIN Number | 84-2760875 |
| Address: | 108 Lilac Drive, Kissimmee, FL, 34743, US |
| Mail Address: | 108 LILAC DRIVE, KISSIMMEE, FL, 34743, US |
| ZIP code: | 34743 |
| County: | Osceola |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1396348082 | 2020-11-17 | 2020-11-17 | 108 LILAC DR, KISSIMMEE, FL, 347436345, US | 108 LILAC DR, KISSIMMEE, FL, 347436345, US | |||||||||||||||||
|
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| Phone | +1 407-734-3417 |
Authorized person
| Name | AMIE PEREIRA |
| Role | AUTHORIZED MEMBER |
| Phone | 4076150448 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PEREIRA AMIE | Agent | 108 LILAC DRIVE, KISSIMMEE, FL, 34743 |
| Name | Role | Address |
|---|---|---|
| PEREIRA AMIE | Auth | 108 LILAC DRIVE, KISSIMMEE, FL, 34743 |
| BOYKINS-ALLEN ANITA | Auth | 108 LILAC DRIVE, KISSIMMEE, FL, 34743 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-29 | 108 Lilac Drive, Kissimmee, FL 34743 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-01-25 |
| Florida Limited Liability | 2019-08-19 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
