| Entity Name: | PSYCHOTHERAPY CENTER OF INDIAN RIVER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 15 Sep 2021 (3 years ago) |
| Document Number: | L21000409151 |
| FEI/EIN Number | 87-2705570 |
| Address: | 1717 20th Street, VERO BEACH, FL, 32960, US |
| Mail Address: | 1717 20th Street, VERO BEACH, FL, 32960, US |
| ZIP code: | 32960 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1689334724 | 2021-12-29 | 2021-12-29 | 1717 20TH ST STE 102, VERO BEACH, FL, 329600619, US | 1717 20TH ST STE 102, VERO BEACH, FL, 329600619, US | |||||||||||||
|
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| Phone | +1 772-584-2501 |
Authorized person
| Name | TABITHA GRANT |
| Role | OWNER THERAPIST |
| Phone | 7725842501 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Dimino Tabitha G | Agent | 1717 20TH STREET, VERO BEACH, FL, 32960 |
| Name | Role | Address |
|---|---|---|
| Dimino Tabitha G | Manager | 1717 20TH STREET, VERO BEACH, FL, 32960 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-07 | 1717 20th Street, Suite 102, VERO BEACH, FL 32960 | No data |
| CHANGE OF MAILING ADDRESS | 2022-04-07 | 1717 20th Street, Suite 102, VERO BEACH, FL 32960 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-04-07 | Dimino, Tabitha Grant | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-19 |
| ANNUAL REPORT | 2023-02-06 |
| ANNUAL REPORT | 2022-04-07 |
| Florida Limited Liability | 2021-09-15 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
