| Entity Name: | ANXIETY TREATMENT OF FLORIDA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 18 Feb 2020 (5 years ago) |
| Document Number: | L20000055507 |
| FEI/EIN Number | 84-4764885 |
| Address: | 162 LONE EAGLE WAY, PONTE VEDRA, FL, 32081, US |
| Mail Address: | PO BOX 2527, PONTE VEDRA BEACH, FL, 32004-2527, US |
| ZIP code: | 32081 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265019376 | 2021-03-25 | 2021-03-25 | PO BOX 2527, PONTE VEDRA BEACH, FL, 320042527, US | 162 LONE EAGLE WAY, PONTE VEDRA, FL, 320818386, US | |||||||||||||
|
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| Phone | +1 904-930-7670 |
Authorized person
| Name | MICHAEL BLOOMQUIST |
| Role | MEMBER |
| Phone | 9049307670 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BLOOMQUIST MICHAEL | Agent | 162 LONE EAGLE WAY, PONTE VEDRA, FL, 32081 |
| Name | Role | Address |
|---|---|---|
| BLOOMQUIST MICHAEL | Manager | PO BOX 2527, PONTE VEDRA BEACH, FL, 320042527 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-01-12 | 162 LONE EAGLE WAY, PONTE VEDRA, FL 32081 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-01-12 | 162 LONE EAGLE WAY, PONTE VEDRA, FL 32081 | No data |
| CHANGE OF MAILING ADDRESS | 2020-10-13 | 162 LONE EAGLE WAY, PONTE VEDRA, FL 32081 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-01-29 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-01-12 |
| Florida Limited Liability | 2020-02-18 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
