| Entity Name: | JOURNEY PSYCHIATRY & BEHAVIORAL HEALTH LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 Mar 2022 (3 years ago) |
| Document Number: | L22000140862 |
| FEI/EIN Number | 88-1364806 |
| Address: | 1540 little rd, Trinity, FL, 34665, US |
| Mail Address: | 1540 little rd, Trinity, FL, 34665, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1144965054 | 2022-05-04 | 2023-01-20 | 4916 26TH ST W STE 158, BRADENTON, FL, 342071712, US | 2710 US 19 ALT, SUITE 403B, PALM HARBOR, FL, 34683, US | |||||||||||||||||||||||
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| Phone | +1 716-444-6169 |
| Fax | 7272388137 |
| Phone | +1 727-748-3954 |
Authorized person
| Name | ROBERT BRADY |
| Role | OWNER |
| Phone | 7164446169 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | APRN LICENSE |
| Number | 11012067 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Brady Robert | Agent | 1540 little rd, Trinity, FL, 34665 |
| Name | Role | Address |
|---|---|---|
| BRADY ROBERT N | Manager | 4125 HANOVER DR, NEW PORT RICHEY, FL, 34653 |
| Name | Role | Address |
|---|---|---|
| BRADY JESSICA J | Authorized Representative | 4215 HANOVER DR, NEW PORT RICHEY, FL, 34653 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000112469 | JOURNEY CENTER FOR ADHD & TRAUMA | ACTIVE | 2024-09-09 | 2029-12-31 | No data | 1815 HEALTHCARE DRIVE, STE B, NEW PORT RICHEY, FL, 34655 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-01-11 | 1540 little rd, E, Trinity, FL 34665 | No data |
| CHANGE OF MAILING ADDRESS | 2024-01-11 | 1540 little rd, E, Trinity, FL 34665 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-01-11 | Brady, Robert | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-01-11 | 1540 little rd, E, Trinity, FL 34665 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-11 |
| ANNUAL REPORT | 2023-01-18 |
| Florida Limited Liability | 2022-03-22 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
