| Entity Name: | MOONRIVER PSYCHOLOGICAL SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 24 Oct 2022 (2 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 16 Oct 2023 (a year ago) |
| Document Number: | L22000455256 |
| FEI/EIN Number | 92-0781149 |
| Address: | 6706 DUNES LANE, TEMPLE TERRACE, FL, 33617, US |
| Mail Address: | 6706 DUNES LANE, TEMPLE TERRACE, FL, 33617, US |
| ZIP code: | 33617 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306624341 | 2023-09-20 | 2023-09-20 | 6706 DUNES LN, TEMPLE TERRACE, FL, 336173207, US | 6706 DUNES LN, TEMPLE TERRACE, FL, 336173207, US | |||||||||||||
|
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| Phone | +1 724-840-5108 |
Authorized person
| Name | DR. ANNA PATRICIA SCHRACK |
| Role | MANAGER |
| Phone | 7248405108 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| TROUTMAN SHANE | Agent | 6706 DUNES LANE, TEMPLE TERRACE, FL, 33617 |
| Name | Role | Address |
|---|---|---|
| SCHRACK ANNA | Manager | 6706 DUNES LANE, TEMPLE TERRACE, FL, 33617 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC STMNT OF RA/RO CHG | 2023-10-16 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2023-10-16 | TROUTMAN, SHANE | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-10-16 | 6706 DUNES LANE, TEMPLE TERRACE, FL 33617 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-26 |
| CORLCRACHG | 2023-10-16 |
| ANNUAL REPORT | 2023-03-03 |
| Florida Limited Liability | 2022-10-24 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
