| Entity Name: | ISLAND COVE BEHAVIORAL PEDIATRICS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 21 Apr 2022 (3 years ago) |
| Document Number: | L22000192008 |
| FEI/EIN Number | 88-1912582 |
| Address: | 1831 Golden Eagle Way, Suites 35, FLEMING ISLAND, FL, 32003, US |
| Mail Address: | 1831 Golden Eagle Way, Suites 35, FLEMING ISLAND, FL, 32003, US |
| ZIP code: | 32003 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184356966 | 2022-06-29 | 2022-06-29 | 2267 TRAILWOOD DR, FLEMING ISLAND, FL, 320034926, US | 2267 TRAILWOOD DR, FLEMING ISLAND, FL, 320034926, US | |||||||||||||
|
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| Phone | +1 904-514-4102 |
Authorized person
| Name | RACHAEL MOHLER |
| Role | CEO |
| Phone | 9045144102 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MOHLER RACHAEL E | Agent | 2267 TRAILWOOD DRIVE, FLEMING ISLAND, FL, 32003 |
| Name | Role | Address |
|---|---|---|
| MOHLER RACHAEL E | Manager | 2267 TRAILWOOD DRIVE, FLEMING ISLAND, FL, 32003 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-01-02 | 1831 Golden Eagle Way, Suites 35, FLEMING ISLAND, FL 32003 | No data |
| CHANGE OF MAILING ADDRESS | 2025-01-02 | 1831 Golden Eagle Way, Suites 35, FLEMING ISLAND, FL 32003 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-02 |
| ANNUAL REPORT | 2024-01-16 |
| ANNUAL REPORT | 2023-04-02 |
| Florida Limited Liability | 2022-04-21 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
