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JACKSONVILLE AUTISM CLINIC, LLC - Florida Company Profile

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Company Details

Entity Name: JACKSONVILLE AUTISM CLINIC, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 06 May 2021 (4 years ago)
Document Number: L21000199179
FEI/EIN Number 86-3724968
Address: 9000 SOUTHSIDE BLVD BLGD 900, JACKSONVILLE, FL, 32256, US
Mail Address: 9000 SOUTHSIDE BLVD BLGD 900, JACKSONVILLE, FL, 32256, US
ZIP code: 32256
City: Jacksonville
County: Duval
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
DUNHAM MICHELLE Chief Executive Officer 9000 SOUTHSIDE BLVD BLGD 900, JACKSONVILLE, FL, 32256
DUNHAM MICHELLE Agent 9000 SOUTHSIDE BLVD BLGD 900, JACKSONVILLE, FL, 32256

National Provider Identifier

NPI Number:
1265016927
Certification Date:
2025-01-16

Authorized Person:

Name:
MRS. HELEN MICHELLE DUNHAM
Role:
EXECUTIVE DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
103K00000X - Behavior Analyst
Is Primary:
No
Selected Taxonomy:
261QR0401X - Comprehensive Outpatient Rehabilitation Facility (CORF)
Is Primary:
No
Selected Taxonomy:
261QM1300X - Multi-Specialty Clinic/Center
Is Primary:
Yes

Contacts:

Documents

Name Date
ANNUAL REPORT 2025-01-24
ANNUAL REPORT 2024-01-05
ANNUAL REPORT 2023-01-10
ANNUAL REPORT 2022-01-24
Florida Limited Liability 2021-05-06

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Date of last update: 03 Aug 2025

Sources: Florida Department of State