| Entity Name: | NEST LIFE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 17 Oct 2019 (5 years ago) |
| Date of dissolution: | 27 Sep 2024 (4 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (4 months ago) |
| Document Number: | L19000261775 |
| FEI/EIN Number | 84-3554865 |
| Address: | 360 Central Avenue, St. Petersburg, FL, 33701, US |
| Mail Address: | 360 Central Avenue, St. Petersburg, FL, 33701, US |
| ZIP code: | 33701 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295371896 | 2019-11-19 | 2023-08-07 | 360 CENTRAL AVE STE 800, ST PETERSBURG, FL, 337013984, US | 360 CENTRAL AVE STE 800, ST PETERSBURG, FL, 337013984, US | |||||||||||||||||||||
|
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| Phone | +1 727-201-2389 |
| Fax | 8552244326 |
Authorized person
| Name | JENNIFER PHELPS |
| Role | PRESIDENT/CEO |
| Phone | 7272012309 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 109269900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Phelps Jennifer R | Agent | 360 Central Avenue, St. Petersburg, FL, 33701 |
| Name | Role | Address |
|---|---|---|
| Phelps Jennifer | Manager | 360 Central Avenue, St. Petersburg, FL, 33701 |
| Jacobson Matthew | Manager | 1111 Abbeys Way, Tampa, FL, 33602 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-02-25 | 360 Central Avenue, Suite 800, St. Petersburg, FL 33701 | No data |
| CHANGE OF MAILING ADDRESS | 2022-02-25 | 360 Central Avenue, Suite 800, St. Petersburg, FL 33701 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-02-25 | 360 Central Avenue, Suite 800, St. Petersburg, FL 33701 | No data |
| LC NAME CHANGE | 2020-10-07 | NEST LIFE, LLC | No data |
| REGISTERED AGENT NAME CHANGED | 2020-06-30 | Phelps, Jennifer R | No data |
| LC NAME CHANGE | 2019-12-27 | LIFETRIBE FLORIDA, LLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2023-04-06 |
| ANNUAL REPORT | 2022-02-25 |
| ANNUAL REPORT | 2021-03-31 |
| LC Name Change | 2020-10-07 |
| ANNUAL REPORT | 2020-06-30 |
| LC Name Change | 2019-12-27 |
| Florida Limited Liability | 2019-10-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
