| Entity Name: | BAY TO BAY BEHAVIORAL HEALTH LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 22 Feb 2021 (4 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | L21000088409 |
| FEI/EIN Number | 86-3588131 |
| Address: | 10312 BLOOMINGDALE AVE, SUITE 108 #142, RIVERVIEW, FL, 33578, UN |
| Mail Address: | 10312 BLOOMINGDALE AVE, SUITE 108 #142, RIVERVIEW, FL, 33578, UN |
| ZIP code: | 33578 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1285380493 | 2022-02-25 | 2022-03-10 | 10312 BLOOMINGDALE AVE STE 108, RIVERVIEW, FL, 335783603, US | 1002 E PALM AVE, TAMPA, FL, 336053550, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 904-323-8349 |
Authorized person
| Name | KELLISHA D PRIESTER |
| Role | CLINICIAN |
| Phone | 5109168013 |
Taxonomy
| Taxonomy Code | 101Y00000X - Counselor |
| Is Primary | No |
| Taxonomy Code | 101YA0400X - Addiction (Substance Use Disorder) Counselor |
| Is Primary | No |
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 171400000X - Health & Wellness Coach |
| Is Primary | No |
| Taxonomy Code | 171M00000X - Case Manager/Care Coordinator |
| Is Primary | No |
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | Yes |
| Taxonomy Code | 251C00000X - Developmentally Disabled Services Day Training Agency |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| Is Primary | No |
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QM0855X - Adolescent and Children Mental Health Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 385HR2050X - Respite Care Camp |
| Is Primary | No |
| Taxonomy Code | 385HR2060X - Child Intellectual and/or Developmental Disabilities Respite Care |
| Is Primary | No |
| Taxonomy Code | 405300000X - Prevention Professional |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| PRIESTER KELLISHA D | Agent | 10312 BLOOMINGDALE AVE, RIVERVIEW, FL, 33578 |
| Name | Role | Address |
|---|---|---|
| PRIESTER KELLISHA D | Chief Executive Officer | 10312 BLOOMINGDALE AVE SUITE 108 #142, RIVERVIEW, FL, 33578 |
| Name | Role | Address |
|---|---|---|
| LEONARD KAVIUS DSR. | Chief Operating Officer | 10312 BLOOMINGDALE AVE SUITE 108 #142, RIVERVIEW, FL, 33578 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-02-15 |
| Florida Limited Liability | 2021-02-22 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
