| Entity Name: | EXPRESSIONS THERAPY CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 21 Apr 2020 (5 years ago) |
| Document Number: | L20000108371 |
| FEI/EIN Number | 85-0874147 |
| Address: | 10203 Count Fleet Dr, Ruskin, FL, 33573, US |
| Mail Address: | 10203 Count Fleet Dr, Ruskin, FL, 33573, US |
| ZIP code: | 33573 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154946358 | 2020-06-12 | 2024-09-26 | 10203 COUNT FLEET DR, RUSKIN, FL, 335736774, US | 10203 COUNT FLEET DR, RUSKIN, FL, 335736774, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 813-843-4645 |
| Phone | +1 813-448-1237 |
| Fax | 8134481237 |
Authorized person
| Name | DIANA ANIOCE-ANDRE |
| Role | THERAPIST |
| Phone | 8138434645 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QM0855X - Adolescent and Children Mental Health Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | LICENSE |
| Number | MH17911 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ANIOCE-ANDRE DIANA | Agent | 10203 Count Fleet Dr, Ruskin, FL, 33573 |
| Name | Role | Address |
|---|---|---|
| Anioce-Andre Diana | Authorized Representative | 10203 Count Fleet Dr, Ruskin, FL, 33573 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-28 | 10203 Count Fleet Dr, Ruskin, FL 33573 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-28 | 10203 Count Fleet Dr, Ruskin, FL 33573 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-28 | 10203 Count Fleet Dr, Ruskin, FL 33573 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-28 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-03-24 |
| Florida Limited Liability | 2020-04-21 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
