| Entity Name: | SUNNYSIDE LOVE EXTRAVAGANT GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 05 Nov 2019 (5 years ago) |
| Date of dissolution: | 25 Dec 2021 (3 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 25 Dec 2021 (3 years ago) |
| Document Number: | L19000272644 |
| FEI/EIN Number | 84-4623878 |
| Address: | 3600 South State Road 7, Miramar, FL, 33023, US |
| Mail Address: | 3600 South State Road 7, Miramar, FL, 33023, US |
| ZIP code: | 33023 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629603154 | 2020-03-04 | 2021-08-08 | 3600 S STATE ROAD 7 STE 344, MIRAMAR, FL, 330237203, US | 3600 S STATE ROAD 7 STE 344, MIRAMAR, FL, 330237203, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 786-575-3801 |
| Fax | 8773842630 |
Authorized person
| Name | TABITHA S TAYLOR-BOONE |
| Role | OWNER |
| Phone | 7865753801 |
Taxonomy
| Taxonomy Code | 101Y00000X - Counselor |
| Is Primary | No |
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 101YP2500X - Professional Counselor |
| Is Primary | No |
| Taxonomy Code | 101YS0200X - School Counselor |
| Is Primary | No |
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | No |
| Taxonomy Code | 104100000X - Social Worker |
| Is Primary | No |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | Yes |
| Taxonomy Code | 1041S0200X - School Social Worker |
| Is Primary | No |
| Taxonomy Code | 174H00000X - Health Educator |
| Is Primary | No |
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 251G00000X - Community Based Hospice Care Agency |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | No |
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1750945689 |
| State | FL |
| Issuer | MEDICAID |
| Number | 022925900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| TAYLOR-BOONE TABITHA S | Agent | 3600 South State Road 7, Miramar, FL, 33023 |
| Name | Role | Address |
|---|---|---|
| Taylor-Boone Tabitha S | Manager | 3600 South State Road 7, Miramar, FL, 33023 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2021-12-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-01-15 | 3600 South State Road 7, Suite 344, Miramar, FL 33023 | No data |
| CHANGE OF MAILING ADDRESS | 2021-01-15 | 3600 South State Road 7, Suite 344, Miramar, FL 33023 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-01-15 | 3600 South State Road 7, Suite 344, Miramar, FL 33023 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2021-12-25 |
| ANNUAL REPORT | 2021-01-15 |
| ANNUAL REPORT | 2020-04-22 |
| Florida Limited Liability | 2019-11-05 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
