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PROVISION THERAPY LLC

Company Details

Entity Name: PROVISION THERAPY LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Company
Status: Active
Date Filed: 29 Dec 2020 (4 years ago)
Document Number: L21000006825
FEI/EIN Number 86-1442787
Address: 3250 DUNLEITH LN, TALLAHASSEE, FL 32311
Mail Address: 3250 DUNLEITH LN, TALLAHASSEE, FL 32311
ZIP code: 32311
County: Leon
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1023609013 2021-02-01 2021-02-22 3250 DUNLEITH LN, TALLAHASSEE, FL, 323113705, US 3250 DUNLEITH LN, TALLAHASSEE, FL, 323113705, US

Contacts

Phone +1 847-565-9156

Authorized person

Name MICHELLE WEEKS
Role MANAGING PARTNER/COO
Phone 8475659156

Taxonomy

Taxonomy Code 225100000X - Physical Therapist
Is Primary Yes
Taxonomy Code 225X00000X - Occupational Therapist
Is Primary No
Taxonomy Code 235Z00000X - Speech-Language Pathologist
Is Primary No

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PROVISION THERAPY LLC-401K 2023 861442787 2024-09-12 PROVISION THERAPY LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-06-01
Business code 621340
Sponsor’s telephone number 8475659156
Plan sponsor’s address 3250 DUNLEITH LANE, TALLAHASSEE, FL, 32311

Signature of

Role Plan administrator
Date 2024-09-12
Name of individual signing NICK RICE
Valid signature Filed with authorized/valid electronic signature
PROVISION THERAPY LLC-401K 2022 861442787 2023-09-12 PROVISION THERAPY LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-06-01
Business code 621340
Sponsor’s telephone number 8475659156
Plan sponsor’s address 3250 DUNLEITH LANE, TALLAHASSEE, FL, 32311

Signature of

Role Plan administrator
Date 2023-09-12
Name of individual signing NICK RICE
Valid signature Filed with authorized/valid electronic signature
PROVISION THERAPY LLC-401K 2021 861442787 2022-07-13 PROVISION THERAPY LLC 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2021-06-01
Business code 621340
Sponsor’s telephone number 8475659156
Plan sponsor’s address 3250 DUNLEITH LANE, TALLAHASSEE, FL, 32311

Signature of

Role Plan administrator
Date 2022-07-13
Name of individual signing SHIRLEY HORNER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
WEEKS, SHAWN Agent 3250 DUNLEITH LN, TALLAHASSEE, FL 32550

Authorized Member

Name Role
SMW CONSULTING GROUP, LLC Authorized Member

Documents

Name Date
ANNUAL REPORT 2024-05-13
ANNUAL REPORT 2023-05-01
AMENDED ANNUAL REPORT 2022-05-28
ANNUAL REPORT 2022-01-19
AMENDED ANNUAL REPORT 2021-05-18
ANNUAL REPORT 2021-01-29
Florida Limited Liability 2020-12-29

Date of last update: 15 Jan 2025

Sources: Florida Department of State