| Entity Name: | PROSPEROUS BEHAVIORAL HEALTH, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 Jul 2022 (3 years ago) |
| Document Number: | L22000325045 |
| FEI/EIN Number | 88-3406992 |
| Address: | 5379 LYONS RD, # 1860, COCONUT CREEK, FL, 33073 |
| Mail Address: | 5379 LYONS RD, # 1860, COCONUT CREEK, FL, 33073 |
| ZIP code: | 33073 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194452631 | 2022-08-04 | 2022-08-04 | 5379 LYONS RD # 1860, COCONUT CREEK, FL, 330732810, US | 4309 W ATLANTIC BLVD APT 917, COCONUT CREEK, FL, 330661758, US | |||||||||||||||||
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| Phone | +1 954-338-9738 |
Authorized person
| Name | FANETTE PROSPERE |
| Role | PMHNP/OWNER |
| Phone | 9543389738 |
Taxonomy
| Taxonomy Code | 261QM0855X - Adolescent and Children Mental Health Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PROSPERE FANETTE | Agent | 6102 Painted Bunting Court, Port St. Lucie, FL, 34986 |
| Name | Role | Address |
|---|---|---|
| Prospere Fanette | Manager | 6102 Painted Bunting Court, Port St. Lucie, FL, 34986 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-17 | 6102 Painted Bunting Court, Port St. Lucie, FL 34986 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-17 |
| ANNUAL REPORT | 2023-04-22 |
| Florida Limited Liability | 2022-07-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
