| Entity Name: | ESSENTIAL GRACE MENTAL HEALTH SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 04 Jan 2021 (4 years ago) |
| Document Number: | L21000011596 |
| FEI/EIN Number | 86-1464718 |
| Address: | 9578 Nims Ln, Pensacola, FL 32534 |
| Mail Address: | 9578 Nims Ln, Pensacola, FL 32534 |
| ZIP code: | 32534 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497437016 | 2023-08-03 | 2023-10-20 | 618 MOHEGAN CIR, CANTONMENT, FL, 325335634, US | 1300 N PALAFOX ST STE 102D, PENSACOLA, FL, 325012678, US | |||||||||||||||
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| Phone | +1 850-619-1276 |
| Phone | +1 850-988-0060 |
Authorized person
| Name | KIMBERLY MURPHY |
| Role | NP |
| Phone | 8509880060 |
Taxonomy
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MURPHY, KIMBERLY | Agent | 618 MOHEGAN CIR, CANTONMENT, FL 32533 |
| Name | Role | Address |
|---|---|---|
| MURPHY, KIMBERLY | Authorized Member | 618 MOHEGAN CIR, CANTONMENT, FL 32533 UN |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-08-21 | 9578 Nims Ln, Pensacola, FL 32534 | No data |
| CHANGE OF MAILING ADDRESS | 2024-08-21 | 9578 Nims Ln, Pensacola, FL 32534 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-21 |
| ANNUAL REPORT | 2023-01-22 |
| ANNUAL REPORT | 2022-03-15 |
| Florida Limited Liability | 2021-01-04 |
Date of last update: 15 Jan 2025
Sources: Florida Department of State
