| Entity Name: | SANKOFA BEHAVIORAL HEALTH SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 13 Jan 2020 (5 years ago) |
| Document Number: | L20000019567 |
| FEI/EIN Number | 84-4469951 |
| Address: | 5379 LENOX AVE., JACKSONVILLE, FL 32205 |
| Mail Address: | 5379 LENOX AVE., JACKSONVILLE, FL 32205 |
| ZIP code: | 32205 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710589205 | 2020-11-10 | 2020-11-10 | PO BOX 8056, JACKSONVILLE, FL, 322390056, US | 5379 LENOX AVE, JACKSONVILLE, FL, 322054737, US | |||||||||||||||||||
|
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| Phone | +1 904-891-6614 |
| Fax | 9045126614 |
Authorized person
| Name | DR. MIA R WILSON |
| Role | LMHC |
| Phone | 9048916614 |
Taxonomy
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 261QM0855X - Adolescent and Children Mental Health Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| WILSON, MIA R, DR. | Agent | 5379 LENOX AVE., JACKSONVILLE, FL 32205 |
| Name | Role | Address |
|---|---|---|
| WILSON, MIA R, MGR | Manager | 5379 LENOX AVE., JACKSONVILLE, FL 32205 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-01-30 | 5379 LENOX AVE., JACKSONVILLE, FL 32205 | No data |
| CHANGE OF MAILING ADDRESS | 2025-01-30 | 5379 LENOX AVE., JACKSONVILLE, FL 32205 | No data |
| REGISTERED AGENT NAME CHANGED | 2025-01-30 | WILSON, MIA R, DR. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2025-01-30 | 5379 LENOX AVE., JACKSONVILLE, FL 32205 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-30 |
| ANNUAL REPORT | 2024-02-13 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-01-28 |
| ANNUAL REPORT | 2021-02-03 |
| Florida Limited Liability | 2020-01-13 |
Date of last update: 15 Feb 2025
Sources: Florida Department of State
