| Entity Name: | ABA LYFE, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 19 Oct 2022 (2 years ago) |
| Document Number: | L22000450919 |
| FEI/EIN Number | APPLIED FOR |
| Address: | 1007 Pineview Blvd Unit C, Unit C, Fort Walton Beach, FL 32547 |
| Mail Address: | 1007 Pineview Blvd Unit C, Unit C, Fort Walton Beach, FL 32547 |
| ZIP code: | 32547 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417639287 | 2023-08-02 | 2023-08-02 | 1007 PINEVIEW BLVD UNIT C, FORT WALTON BEACH, FL, 325471499, US | 1007 PINEVIEW BLVD UNIT C, FORT WALTON BEACH, FL, 325471499, US | |||||||||||||
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| Phone | +1 925-337-7384 |
Authorized person
| Name | TAYLOR DETHEROW |
| Role | BCBA |
| Phone | 9253377384 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DETHEROW, TAYLOR | Agent | 1007 Pineview Blvd Unit C, Unit C, Fort Walton Beach, FL 32547 |
| Name | Role | Address |
|---|---|---|
| DETHEROW, TAYLOR | Authorized Member | 1007 Pineview Blvd Unit C, Unit C, Fort Walton Beach, FL 32547 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-03-29 | 1007 Pineview Blvd Unit C, Unit C, Fort Walton Beach, FL 32547 | No data |
| CHANGE OF MAILING ADDRESS | 2023-03-29 | 1007 Pineview Blvd Unit C, Unit C, Fort Walton Beach, FL 32547 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-03-29 | DETHEROW, TAYLOR | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-29 | 1007 Pineview Blvd Unit C, Unit C, Fort Walton Beach, FL 32547 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-30 |
| ANNUAL REPORT | 2023-03-29 |
| Florida Limited Liability | 2022-10-19 |
Date of last update: 11 Feb 2025
Sources: Florida Department of State
