| Entity Name: | RESOURCES FOR MENTAL WELLNESS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 20 Sep 2021 (3 years ago) |
| Document Number: | L21000414674 |
| FEI/EIN Number | 87-2736195 |
| Address: | 4190 BELFORT RD STE 130, JACKSONVILLE, FL 32216 |
| Mail Address: | 4190 Belfort Rd, Suite 130, Jacksonville, FL 32216 |
| ZIP code: | 32216 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1144991134 | 2021-09-21 | 2024-06-03 | 4190 BELFORT RD STE 130, JACKSONVILLE, FL, 322165871, US | 4190 BELFORT RD STE 130, JACKSONVILLE, FL, 322165871, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 904-776-6555 |
| Phone | +1 904-776-3188 |
Authorized person
| Name | DEANA ROBERTS |
| Role | VP/ QUALITY ASSURANCE |
| Phone | 9047766555 |
Taxonomy
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | Yes |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 112766700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Roberts, Deana | Agent | 4190 BELFORT RD STE 130, JACKSONVILLE, FL 32216 |
| Name | Role | Address |
|---|---|---|
| GLOSTER, ROBIN | President | 4190 BELFORT RD STE 130, JACKSONVILLE, FL 32216 |
| Name | Role | Address |
|---|---|---|
| ROBERTS, DEANA | Vice President | 4190 BELFORT RD STE 130, JACKSONVILLE, FL 32216 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2023-04-05 | 4190 BELFORT RD STE 130, JACKSONVILLE, FL 32216 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-04-05 | Roberts, Deana | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-05 | 4190 BELFORT RD STE 130, JACKSONVILLE, FL 32216 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-01-30 | 4190 BELFORT RD STE 130, JACKSONVILLE, FL 32216 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-23 |
| AMENDED ANNUAL REPORT | 2023-04-05 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-04-19 |
| Florida Limited Liability | 2021-09-20 |
Date of last update: 13 Jan 2025
Sources: Florida Department of State
