| Entity Name: | REVAMED CENTER FOR EMOTIONAL WELLBEING, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 28 Jul 2020 (5 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 24 Sep 2020 (4 years ago) |
| Document Number: | L20000224502 |
| FEI/EIN Number | 85-2205050 |
| Address: | 7000 W PALMETTO PARK RD, 201, BOCA RATON, FL, 33433, US |
| Mail Address: | 6056 BOYNTON BEACH BLVD, SUITE 115, BOYNTON BEACH, FL, 33472, US |
| ZIP code: | 33433 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093325243 | 2020-08-03 | 2020-08-03 | 8140 OKEECHOBEE BLVD STE A&B, WEST PALM BEACH, FL, 334112003, US | 7000 W PALMETTO PARK RD STE 201, BOCA RATON, FL, 334333430, US | |||||||||||||||||||||||||||||||
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| Phone | +1 561-293-4301 |
| Fax | 5612934301 |
| Phone | +1 561-391-2770 |
| Fax | 5613912930 |
Authorized person
| Name | MELISSA STIELER |
| Role | CREDENTIALING MANAGER |
| Phone | 5614322164 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | No |
| Taxonomy Code | 2080P0006X - Developmental - Behavioral Pediatrics Physician |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
| Taxonomy Code | 364SP0807X - Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist |
| Is Primary | No |
| Name | Role |
|---|---|
| FILS INTERNATIONAL CONSULTING GROUP, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| BASTIEN-MONTPEIROUS NATHALIE | Manager | 15430 MEADOW WOOD DRIVE, WELLINGTON, FL, 33414 |
| Name | Role |
|---|---|
| REVAMED HEALTHCARE PARTNERS, LLC | Authorized Member |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-04-29 | Fils International Consulting Group Inc | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-29 | 1645 Palm Beach Lakes Blvd, Suite 1200, West Palm Beach, FL 33401 | No data |
| CHANGE OF MAILING ADDRESS | 2022-04-21 | 7000 W PALMETTO PARK RD, 201, BOCA RATON, FL 33433 | No data |
| LC AMENDMENT | 2020-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-29 |
| ANNUAL REPORT | 2022-04-21 |
| ANNUAL REPORT | 2021-03-16 |
| LC Amendment | 2020-09-24 |
| Florida Limited Liability | 2020-07-28 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
