| Entity Name: | LOTUS BEHAVIOR SOLUTIONS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 06 Jun 2022 (3 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 18 Nov 2022 (2 years ago) |
| Document Number: | L22000257332 |
| FEI/EIN Number | 88-2746893 |
| Address: | 421 WINDRUSH BAY DRIVE, TARPON SPRINGS, FL, 34689, US |
| Mail Address: | 421 WINDRUSH BAY DRIVE, TARPON SPRINGS, FL, 34689, US |
| ZIP code: | 34689 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013639772 | 2022-09-19 | 2022-09-19 | 421 WINDRUSH BAY DR, TARPON SPRINGS, FL, 346891205, US | 421 WINDRUSH BAY DR, TARPON SPRINGS, FL, 346891205, US | |||||||||||||||||||
|
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| Phone | +1 727-412-1007 |
Authorized person
| Name | KELLY FLYNN |
| Role | BCBA |
| Phone | 7274121007 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 113045400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FLYNN KELLY | Agent | 421 WINDRUSH BAY DRIVE, TARPON SPRINGS, FL, 34689 |
| Name | Role | Address |
|---|---|---|
| FLYNN KELLY | Manager | 421 WINDRUSH BAY DRIVE, TARPON SPRINGS, FL, 34689 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2022-11-18 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-11-18 | FLYNN, KELLY | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-11-18 | 421 WINDRUSH BAY DRIVE, TARPON SPRINGS, FL 34689 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-24 |
| ANNUAL REPORT | 2023-04-17 |
| LC Amendment | 2022-11-18 |
| Florida Limited Liability | 2022-06-06 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
