| Entity Name: | PROFESSIONAL MENTAL HEALTH WELLNESS SERVICES, L.L.C |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 02 Mar 2022 (3 years ago) |
| Document Number: | L22000107533 |
| FEI/EIN Number | 88-1257430 |
| Address: | 10564 NW SR 20 Suite #2, Bristol, FL 32321 |
| Mail Address: | PO BOX 443, HOSFORD, FL 32334 UN |
| ZIP code: | 32321 |
| County: | Liberty |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659013548 | 2022-04-11 | 2022-08-29 | PO BOX 443, HOSFORD, FL, 323340443, US | 10564 NW SR 20 SUITE #2, BRISTOL, FL, 32321, US | |||||||||||||
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| Phone | +1 850-447-4644 |
Authorized person
| Name | MRS. KRISTINA A RICKMAN-SYKES |
| Role | PMHNP |
| Phone | 8504474644 |
Taxonomy
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| RICKMAN-SYKES, KRISTINA A | Agent | 10564 NW SR 20 Suite # 2, # 2, Bristol, FL 32321 |
| Name | Role | Address |
|---|---|---|
| Rickman-Sykes, Kristina ,A | owner | 10564 NW SR 20 Suite # 2, Bristol, FL 32321 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-04 | 10564 NW SR 20 Suite # 2, # 2, Bristol, FL 32321 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-09-21 | 10564 NW SR 20 Suite #2, Bristol, FL 32321 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-04-04 |
| Florida Limited Liability | 2022-03-02 |
Date of last update: 12 Jan 2025
Sources: Florida Department of State
