| Entity Name: | GRACE WELLNESS CENTER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 27 May 2020 (5 years ago) |
| Document Number: | L20000144380 |
| FEI/EIN Number | 851195658 |
| Address: | 2504 ACORN ST, FORT PIERCE, FL, 34947, US |
| Mail Address: | 2504 ACORN ST, fort pierce, FL, 34947, US |
| ZIP code: | 34947 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497371108 | 2020-06-18 | 2022-03-16 | 2504 ACORN STREET, STE A, FORT PIERCE, FL, 34947, US | 2504 ACORN ST STE A, FORT PIERCE, FL, 349474746, US | |||||||||||||||||||||||||||
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| Phone | +1 772-837-7800 |
| Fax | 7728377801 |
Authorized person
| Name | BARBIE BRUNET |
| Role | OWNER/PROVIDER |
| Phone | 7728377800 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 363LP2300X - Primary Care Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| BRUNET BARBIE | Agent | 2504 ACORN ST, FORT PIERCE, FL, 34947 |
| Name | Role | Address |
|---|---|---|
| BRUNET BARBIE | Manager | 2504 ACORN STREET, SUITE A, FORT PIERCE, FL, 34947 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-14 | 2504 ACORN ST, Suite A, FORT PIERCE, FL 34947 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-01-06 | 2504 ACORN ST, Suite A, FORT PIERCE, FL 34947 | No data |
| CHANGE OF MAILING ADDRESS | 2023-01-06 | 2504 ACORN ST, Suite A, FORT PIERCE, FL 34947 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-14 |
| ANNUAL REPORT | 2023-02-03 |
| ANNUAL REPORT | 2022-05-05 |
| ANNUAL REPORT | 2021-03-09 |
| Florida Limited Liability | 2020-05-27 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
