| Entity Name: | PRESTIGE RECOVERY AND SUBOXONE CLINIC LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 13 Mar 2023 (2 years ago) |
| Document Number: | L23000127859 |
| FEI/EIN Number | APPLIED FOR |
| Mail Address: | 301 SW 1ST AVE, 2019, FORT LAUDERDALE, FL, 33301, US |
| Address: | 3800 WEST BOWARD BLVD, FORT LAUDERDALE, FL, 33312, US |
| ZIP code: | 33312 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215623624 | 2023-04-18 | 2024-03-20 | 3800 W BROWARD BLVD, FORT LAUDERDALE, FL, 333121018, US | 3800 W BROWARD BLVD, FORT LAUDERDALE, FL, 333121018, US | |||||||||||||||||
|
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| Phone | +1 954-496-2599 |
Authorized person
| Name | HENRY ODAZIE |
| Role | CEO |
| Phone | 9544962599 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| HENSTEL INVESTMENT LLC | Agent | 1309 COFFEEN AVENUE , WY, SHERIDAN, WY, FL, 82801 |
| Name | Role | Address |
|---|---|---|
| HENSTEL INVESTMENT LLC | Authorized Person | 1309 COFFEEN AVENUE,, SHERIDAN,, WY, 82801 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-06-01 | 3800 WEST BOWARD BLVD, FORT LAUDERDALE, FL 33312 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-06-01 |
| Florida Limited Liability | 2023-03-13 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
