| Entity Name: | THERAPY WEST 2, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 09 Jan 2023 (2 years ago) |
| Document Number: | L23000018600 |
| FEI/EIN Number | 92-1660653 |
| Address: | 400 S. Orlando Ave, Suite 204, Maitland, FL 32751 |
| Mail Address: | 400 S. Orlando Ave, Suite 204, Maitland, FL 32751 |
| ZIP code: | 32751 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366141293 | 2023-02-28 | 2024-06-05 | 400 S ORLANDO AVE STE 204, MAITLAND, FL, 327515644, US | 400 S ORLANDO AVE STE 204, MAITLAND, FL, 327515644, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 407-400-3026 |
Authorized person
| Name | DOMINIQUE KIEFER |
| Role | OWNER |
| Phone | 4079003026 |
Taxonomy
| Taxonomy Code | 225X00000X - Occupational Therapist |
| Is Primary | Yes |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QD1600X - Developmental Disabilities Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QR0400X - Rehabilitation Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| KIEFER, DOMINIQUE | Agent | 1245 BELFIORE WAY, WINDERMERE, FL 34786 |
| Name | Role | Address |
|---|---|---|
| KIEFER, DOMINIQUE | Authorized Representative | 1245 BELFIORE WAY, WINDERMERE, FL 34786 |
| WHITE, BETH | Authorized Representative | 1621 CHINOOK TRAIL, MAITLAND, FL 32751 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-07-17 | 400 S. Orlando Ave, Suite 204, Maitland, FL 32751 | No data |
| CHANGE OF MAILING ADDRESS | 2023-07-17 | 400 S. Orlando Ave, Suite 204, Maitland, FL 32751 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-10 |
| Florida Limited Liability | 2023-01-09 |
Date of last update: 10 Jan 2025
Sources: Florida Department of State
