| Entity Name: | MIND & BODY BEHAVIORAL HEALTH LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 19 Dec 2022 (2 years ago) |
| Document Number: | L22000530381 |
| FEI/EIN Number | 92-1433841 |
| Address: | 4609 US HIGHWAY 17, SUITE 1, FLEMING ISLAND, FL, 32003, US |
| Mail Address: | 4609 US HIGHWAY 17, SUITE 1, FLEMING ISLAND, FL, 32003, US |
| ZIP code: | 32003 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184336919 | 2022-12-26 | 2022-12-26 | 4609 US HIGHWAY 17 STE 1, FLEMING ISLAND, FL, 320034818, US | 4609 US HIGHWAY 17 STE 1, FLEMING ISLAND, FL, 320034818, US | |||||||||||||
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| Phone | +1 904-375-2353 |
Authorized person
| Name | MS. JILL ROCKEY |
| Role | APRN |
| Phone | 9043752353 |
Taxonomy
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ROCKEY JILL | Agent | 4609 US HIGHWAY 17, FLEMING ISLAND, FL, 32003 |
| Name | Role | Address |
|---|---|---|
| ROCKEY JILL | Managing Member | 4609 US HIGHWAY 17, FLEMING ISLAND, FL, 32003 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000161134 | FYZICAL THERAPY & BALANCE CENTERS | ACTIVE | 2022-12-29 | 2027-12-31 | No data | 4609 US HIGHWAY 17, SUITE 1, FLEMING ISLAND, FL, 32003 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-02-08 | ROCKEY, JILL | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-08 | 4609 US HIGHWAY 17, SUITE 1, FLEMING ISLAND, FL 32003 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-08 |
| ANNUAL REPORT | 2023-04-19 |
| Florida Limited Liability | 2022-12-19 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
