| Entity Name: | ATHENA BEHAVIOR ANALYSIS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 11 Sep 2019 (5 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | L19000229956 |
| FEI/EIN Number | 84-3123396 |
| Address: | 1230 FARGO DRIVE, MELBOURNE, FL, 32940, US |
| Mail Address: | 1230 FARGO DRIVE, MELBOURNE, FL, 32940, US |
| ZIP code: | 32940 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629687686 | 2020-07-27 | 2023-11-27 | 1230 FARGO DR, MELBOURNE, FL, 329406901, US | 1230 FARGO DR, MELBOURNE, FL, 329406901, US | |||||||||||||||||||
|
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| Phone | +1 424-302-3643 |
Authorized person
| Name | MAUREEN GAMACHE |
| Role | OWNER |
| Phone | 4243023643 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 105117700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GAMACHE MAUREEN | Agent | 1230 FARGO DRIVE, MELBOURNE, FL, 32940 |
| Name | Role | Address |
|---|---|---|
| GAMACHE MAUREEN | Manager | 1230 FARGO DRIVE, MELBOURNE, FL, 32940 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-04-18 |
| ANNUAL REPORT | 2020-07-17 |
| Florida Limited Liability | 2019-09-11 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
