| Entity Name: | FULLY ALIVE THERAPIES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 10 Jan 2022 (3 years ago) |
| Document Number: | L22000018960 |
| FEI/EIN Number | 87-4590776 |
| Address: | 5128 ARBOR GLEN CIRCLE, LAKE WORTH, FL 33463 |
| Mail Address: | 5128 ARBOR GLEN CIRCLE, LAKE WORTH, FL 33463 |
| ZIP code: | 33463 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750018305 | 2022-08-03 | 2022-08-03 | 5128 ARBOR GLEN CIR, LAKE WORTH, FL, 334638043, US | 5128 ARBOR GLEN CIR, LAKE WORTH, FL, 334638043, US | |||||||||||||
|
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| Phone | +1 630-216-9881 |
Authorized person
| Name | JITHIN JOSEPH GEORGE |
| Role | OWNER |
| Phone | 6302169881 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GEORGE, JITHIN J | Agent | 5128 ARBOR GLEN CIRCLE, LAKE WORTH, FL 33463 |
| Name | Role | Address |
|---|---|---|
| GEORGE, JITHIN J | Authorized Person | 5128 ARBOR GLEN CIRCLE, LAKE WORTH, FL 33463 |
| GEORGE, YAMILE G | Authorized Person | 5128 ARBOR GLEN CIRCLE, LAKE WORTH, FL 33463 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-06 |
| ANNUAL REPORT | 2024-02-03 |
| ANNUAL REPORT | 2023-03-12 |
| Florida Limited Liability | 2022-01-10 |
Date of last update: 12 Feb 2025
Sources: Florida Department of State
