| Entity Name: | G&A BEHAVIOR GROUP LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 07 Jul 2022 (3 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | L22000303453 |
| FEI/EIN Number | 883192622 |
| Address: | 8192 College Pkyers, Fort Myers, FL, 33919, US |
| Mail Address: | 8192 College Pkyers, Fort Myers, FL, 33919, US |
| ZIP code: | 33919 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104550128 | 2022-07-14 | 2022-07-14 | 8192 COLLEGE PKWY STE A3, FORT MYERS, FL, 339195196, US | 8192 COLLEGE PKWY STE A3, FORT MYERS, FL, 339195196, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 786-296-5106 |
Authorized person
| Name | AILIME TAYLOR |
| Role | BCBA |
| Phone | 3052006636 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | No |
| Taxonomy Code | 106E00000X - Assistant Behavior Analyst |
| Is Primary | No |
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 0000000000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MANRIQUE GINA | Agent | 2407 CASLOTTI WAY, CAPE CORAL, FL, 33909 |
| Name | Role | Address |
|---|---|---|
| MANRIQUE GINA | Authorized Member | 2407 CASLOTTI WAY, CAPE CORAL, FL, 33909 |
| TAYLOR AILIME | Authorized Member | 9552 SW 148TH AVE CIR N, CAPE CORAL, FL, 33909 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-08-01 | 8192 College Pkyers, Fort Myers, FL 33919 | No data |
| CHANGE OF MAILING ADDRESS | 2022-08-01 | 8192 College Pkyers, Fort Myers, FL 33919 | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2022-07-07 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
