| Entity Name: | OLIVE 360 BEHAVIORAL HEALTH |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 19 Jan 2023 (2 years ago) |
| Date of dissolution: | 27 Sep 2024 (4 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (4 months ago) |
| Document Number: | L23000035073 |
| Address: | 117 SW 10TH ST, 101-257, MIAMI, FL, 33130 |
| Mail Address: | 117 SW 10TH ST, 101-257, MIAMI, FL, 33130 |
| ZIP code: | 33130 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891495636 | 2023-03-09 | 2023-03-09 | 117 SW 10TH ST # 101-257, MIAMI, FL, 331303555, US | 201 S BISCAYNE BLVD, MIAMI, FL, 331314332, US | |||||||||||||||||||||
|
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| Phone | +1 833-378-2552 |
Authorized person
| Name | LISA WILKINSON |
| Role | PROVIDER |
| Phone | 8333782552 |
Taxonomy
| Taxonomy Code | 101Y00000X - Counselor |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
| Taxonomy Code | 261QM0855X - Adolescent and Children Mental Health Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| WILKINSON LISA | Agent | 117 SW 10TH ST 101-257, MIAMI, FL, 33130 |
| Name | Role | Address |
|---|---|---|
| WILKINSON LISA | Manager | 117 SW 10TH ST UNIT 101-257, MIAMI, FL, 33130 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2023-01-19 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
