| Entity Name: | LAUREL GRACE MENTAL HEALTH AND WELLNESS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 17 Mar 2023 (2 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 31 May 2023 (2 years ago) |
| Document Number: | L23000137519 |
| FEI/EIN Number | 92-3073059 |
| Address: | 9614 Troncais Cir, Thonotosassa, FL 33592 |
| Mail Address: | 5313 Trace Ridge Cir, Hoover, AL 35244-3928 |
| ZIP code: | 33592 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154024966 | 2023-03-22 | 2023-03-22 | 9614 TRONCAIS CIR, THONOTOSASSA, FL, 335923412, US | 9614 TRONCAIS CIR, THONOTOSASSA, FL, 335923412, US | |||||||||||||
|
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| Phone | +1 612-388-4661 |
Authorized person
| Name | LALENCIA L MATTHEWS |
| Role | CEO |
| Phone | 6123884661 |
Taxonomy
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MATTHEWS, LALENCIA L | Agent | 9614 TRONCAIS CIRCLE, THONOTOSASSA, FL 33592 |
| Name | Role | Address |
|---|---|---|
| MATTHEWS, LALENCIA | Manager | 9614 TRONCAIS CIRCLE, THONOTOSASSA, FL 33592 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-05 | 9614 Troncais Cir, Thonotosassa, FL 33592 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-05 | 9614 Troncais Cir, Thonotosassa, FL 33592 | No data |
| LC AMENDMENT | 2023-05-31 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-05 |
| LC Amendment | 2023-05-31 |
| Florida Limited Liability | 2023-03-17 |
Date of last update: 10 Jan 2025
Sources: Florida Department of State
