| Entity Name: | NEIGHBORHOOD THERAPY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 05 Jan 2023 (2 years ago) |
| Document Number: | L23000011464 |
| FEI/EIN Number | 92-1696567 |
| Mail Address: | 4530-15 St Johns Avenue, #117, JACKSONVILLE, FL 32210 |
| Address: | 1239 Belvedere Avenue, JACKSONVILLE, FL 32205 |
| ZIP code: | 32205 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881300077 | 2023-01-30 | 2023-01-30 | 1239 BELVEDERE AVE, JACKSONVILLE, FL, 322057940, US | 1239 BELVEDERE AVE, JACKSONVILLE, FL, 322057940, US | |||||||||||||||||||
|
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| Phone | +1 321-795-7829 |
Authorized person
| Name | MRS. CARLY MORGAN TRAVERSA |
| Role | CHIEF EXECUTIVE OFFICER |
| Phone | 3217957829 |
Taxonomy
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1265035026 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| TRAVERSA, CARLY M | Agent | 4530-15 St Johns Avenue, #117, JACKSONVILLE, FL 32210 |
| Name | Role | Address |
|---|---|---|
| TRAVERSA, CARLY M | Manager | 4530-15 St Johns Avenue, #117 JACKSONVILLE, FL 32210 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-01-13 | 1239 Belvedere Avenue, JACKSONVILLE, FL 32205 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-28 | 4530-15 St Johns Avenue, #117, JACKSONVILLE, FL 32210 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-28 | 4530-15 St Johns Avenue, #117, JACKSONVILLE, FL 32210 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-28 | 4530-15 St Johns Avenue, #117, JACKSONVILLE, FL 32210 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-28 |
| Florida Limited Liability | 2023-01-05 |
Date of last update: 10 Feb 2025
Sources: Florida Department of State
