| Entity Name: | JT BEHAVIORAL MILESTONES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 24 Mar 2021 (4 years ago) |
| Document Number: | L21000137741 |
| FEI/EIN Number | 86-2809309 |
| Address: | 235 N Westmore Dr, Altamonte Springs, FL, 32714, US |
| Mail Address: | PO Box 520880, Longwood, FL, 32752, US |
| ZIP code: | 32714 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851040273 | 2022-03-22 | 2022-03-22 | 100 MYRTLE ST APT 336208, LONGWOOD, FL, 327505398, US | 100 MYRTLE ST APT 336, LONGWOOD, FL, 327505431, US | |||||||||||||||||||||||||||||||
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| Phone | +1 863-307-1290 |
Authorized person
| Name | JILLISA TARVER |
| Role | OWNER |
| Phone | 8633071290 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | Yes |
| Taxonomy Code | 320600000X - Intellectual and/or Developmental Disabilities Residential Treatment Facility |
| Is Primary | No |
| Taxonomy Code | 320900000X - Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| Is Primary | No |
| Taxonomy Code | 343900000X - Non-emergency Medical Transport (VAN) |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 106312600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| TARVER JILLISA C | Agent | 501 Florida Central Pkwy, Longwood, FL, 32752 |
| Name | Role | Address |
|---|---|---|
| TARVER JILLISA | Manager | PO Box, Longwood, FL, 32752 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-10-17 | 235 N Westmore Dr, Altamonte Springs, FL 32714 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-19 | 235 N Westmore Dr, Altamonte Springs, FL 32714 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-19 | 501 Florida Central Pkwy, 520880, Longwood, FL 32752 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-19 |
| ANNUAL REPORT | 2023-03-13 |
| ANNUAL REPORT | 2022-04-22 |
| Florida Limited Liability | 2021-03-24 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
