| Entity Name: | MENTUS BEHAVIORAL HEALTH, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 29 Nov 2021 (3 years ago) |
| Document Number: | L21000505310 |
| FEI/EIN Number | 87-4184978 |
| Address: | 12651 McGregor Boulevard, Suite 3-301, Fort Myers, FL 33919 |
| Mail Address: | 12651 McGregor Boulevard, Suite 3-301, Fort Myers, FL 33919 |
| ZIP code: | 33919 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700533536 | 2022-03-02 | 2022-08-15 | 12651 MCGREGOR BLVD STE 301, FORT MYERS, FL, 339194488, US | 12651 MCGREGOR BLVD STE 301, FORT MYERS, FL, 339194488, US | |||||||||||||
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| Phone | +1 704-770-7027 |
Authorized person
| Name | DR. LUIS EMILIO BETANCOURT |
| Role | CHIEF MEDICAL OFFICER |
| Phone | 7047707027 |
Taxonomy
| Taxonomy Code | 2084P0804X - Child & Adolescent Psychiatry Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| TABRAUE, GUILLERMO, III | Agent | 150 SE SECOND AVENUE, SUITE 1410, MIAMI, FL 33131 |
| Name | Role | Address |
|---|---|---|
| TABRAUE, GUILLERMO, III | Managing Member | 12651 McGregor Boulevard, Suite 3-301 Fort Myers, FL 33919 |
| BETANCOURT, LUIS | Managing Member | 12651 McGregor Boulevard, Suite 3-301 Fort Myers, FL 33919 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000011245 | MENTUS HEALTH | ACTIVE | 2024-01-19 | 2029-12-31 | No data | 12651 MCGREGOR BOULEVARD, SUITE 3-301, FORT MYERS, FL, 33919 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2023-04-05 | 12651 McGregor Boulevard, Suite 3-301, Fort Myers, FL 33919 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-11 | 12651 McGregor Boulevard, Suite 3-301, Fort Myers, FL 33919 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-11 |
| ANNUAL REPORT | 2023-04-05 |
| ANNUAL REPORT | 2022-04-11 |
| Florida Limited Liability | 2021-11-29 |
Date of last update: 13 Jan 2025
Sources: Florida Department of State
