| Entity Name: | VINTAGE PSYCHIATRIC CARE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 05 Apr 2023 (2 years ago) |
| Document Number: | L23000169817 |
| FEI/EIN Number | 92-2200809 |
| Address: | 7163 HIAWASSEE OAK DR, ORLANDO, FL, 32818, UN |
| Mail Address: | 7163 HIAWASSEE OAK DR, ORLANDO, FL, 32818, UN |
| ZIP code: | 32818 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255038477 | 2023-02-08 | 2023-02-08 | 7163 HIAWASSEE OAK DR, ORLANDO, FL, 328188357, US | 7163 HIAWASSEE OAK DR, ORLANDO, FL, 328188357, US | |||||||||||||
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| Phone | +1 407-237-0399 |
Authorized person
| Name | VADA PARKE-GASKIN |
| Role | FOUNDER |
| Phone | 4072370399 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PARKE-GASKIN VADA C | Agent | 7163 HIAWASSEE OAK DR, ORLANDO, FL, 32818 |
| Name | Role | Address |
|---|---|---|
| PARKE-GASKIN VADA C | Chief Financial Officer | 7163 HIAWASSEE OAK DR, ORLANDO, FL, 32818 |
| Campbell Bevon CJr. | Chief Financial Officer | 7163 HIAWASSEE OAK DR, ORLANDO, FL, 32818 |
| Name | Role | Address |
|---|---|---|
| PARKE-GASKIN VINTAGE V | Manager | 7163 HIAWASSEE OAK DR, ORLANDO, FL, 32818 |
| GASKIN KADEN M | Manager | 7163 HIAWASSEE OAK DR, ORLANDO, FL, 32818 |
| Name | Role | Address |
|---|---|---|
| GASKIN KAI M | Chief Executive Officer | 7163 HIAWASSEE OAK DR, ORLANDO, FL, 32818 |
| Name | Role | Address |
|---|---|---|
| GASKIN KACE J | Authorized Member | 7163 HIAWASSEE OAK DR, ORLANDO, FL, 32818 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-22 |
| Florida Limited Liability | 2023-04-05 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
