| Entity Name: | BLOSSOM BEHAVIORAL SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 10 May 2021 (4 years ago) |
| Document Number: | L21000216783 |
| FEI/EIN Number | 87-0844308 |
| Address: | 4263 NEVADA STREET, AVE MARIA, FL, 34142, US |
| Mail Address: | 4263 NEVADA STREET, AVE MARIA, FL, 34142, US |
| ZIP code: | 34142 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912572330 | 2021-05-26 | 2021-05-26 | 4263 NEVADA ST, AVE MARIA, FL, 341425028, US | 4263 NEVADA ST, AVE MARIA, FL, 341425028, US | |||||||||||||||||||||
|
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| Phone | +1 954-882-2142 |
Authorized person
| Name | TELMA SUARES |
| Role | OWNER |
| Phone | 9548822142 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | Yes |
| Taxonomy Code | 225X00000X - Occupational Therapist |
| Is Primary | No |
| Taxonomy Code | 261QH0700X - Hearing and Speech Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| SUARES TELMA | Agent | 4263 NEVADA STREET, AVE MARIA, FL, 34142 |
| Name | Role | Address |
|---|---|---|
| SUARES TELMA | Manager | 4263 NEVADA STREET, AVE MARIA, FL, 34142 |
| SOUZA JOABE | Manager | 4263 NEVADA STREET, AVE MARIA, FL, 34142 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000156297 | SUCCESS ON THE SPECTRUM | ACTIVE | 2021-11-23 | 2026-12-31 | No data | 4263 NEVADA ST, AVE MARIA, FL, 34142 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-13 |
| ANNUAL REPORT | 2024-02-09 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-04-01 |
| Florida Limited Liability | 2021-05-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
