| Entity Name: | OASIS MENTAL HEALTH CENTER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 14 Oct 2019 (5 years ago) |
| Document Number: | L19000257678 |
| FEI/EIN Number | 84-3580840 |
| Address: | 5901 NW 183RD ST, STE 310, HIALEAH, FL 33015 |
| Mail Address: | 5901 NW 183RD ST, STE 310, HIALEAH, FL 33015 |
| ZIP code: | 33015 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093350357 | 2019-11-11 | 2023-01-09 | 5901 NW 183RD ST STE 310, HIALEAH, FL, 330156008, US | 5901 NW 183RD ST STE 310, HIALEAH, FL, 330156008, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 786-418-9790 |
| Fax | 7863586063 |
Authorized person
| Name | DEIVY CALVO |
| Role | OWNER |
| Phone | 7864189790 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | No |
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 107090600 |
| State | FL |
| Issuer | MEDICAID |
| Number | 104765400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CALVO HERNANDEZ, DEIVY | Agent | 5901 NW 183RD ST, STE 310, HIALEAH, FL 33015 |
| Name | Role | Address |
|---|---|---|
| CALVO HERNANDEZ, DEIVY | Manager | 12450 SW 49th St, Apt 11206 Miramar, FL 33027 |
| HERNANDEZ, ALEIDA | Manager | 5665 W 20TH AVE, APT 315, HIALEAH, FL 33012 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000087345 | OASIS MEDCARE | ACTIVE | 2022-07-24 | 2027-12-31 | No data | 5901 NW 183RD ST, STE 310, HIALEAH, FL, 33015 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2022-02-28 | 5901 NW 183RD ST, STE 310, HIALEAH, FL 33015 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-07-29 | 5901 NW 183RD ST, STE 310, HIALEAH, FL 33015 | No data |
| CHANGE OF MAILING ADDRESS | 2021-07-29 | 5901 NW 183RD ST, STE 310, HIALEAH, FL 33015 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-04 |
| ANNUAL REPORT | 2023-03-04 |
| ANNUAL REPORT | 2022-02-28 |
| ANNUAL REPORT | 2021-02-17 |
| ANNUAL REPORT | 2020-02-29 |
| Florida Limited Liability | 2019-10-14 |
Date of last update: 16 Jan 2025
Sources: Florida Department of State
