| Entity Name: | JACKIE'S MENTAL HEALTH MANAGEMENT SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 May 2023 (2 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 20 Nov 2023 (a year ago) |
| Document Number: | L23000214877 |
| FEI/EIN Number | 92-3835891 |
| Address: | 86147 AUGUSTUS AVE., YULEE, FL, 32097, US |
| Mail Address: | 86147 AUGUSTUS AVE, YULEE, FL, 32097, US |
| ZIP code: | 32097 |
| County: | Nassau |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457043622 | 2023-05-24 | 2023-09-22 | 86147 AUGUSTUS AVE, YULEE, FL, 320973881, US | 86147 AUGUSTUS AVE, YULEE, FL, 320973881, US | |||||||||||||||||
|
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| Phone | +1 904-463-7833 |
Authorized person
| Name | JACQUELYN HILL |
| Role | PSYCHIATRIC NURSE PRACTITIONER |
| Phone | 9044637833 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HILL JACQUELYN | Agent | 86147 AUGUSTUS AVE, YULEE, FL, 32097 |
| Name | Role | Address |
|---|---|---|
| HILL JACQUELYN | Manager | 86147 AUGUSTUS AVE., YULEE, FL, 32097 |
| Name | Role | Address |
|---|---|---|
| HILL JACQUELYN | Authorized Member | 86147 AUGUSTUS AVE., YULEE, FL, 32097 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2023-11-20 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-07 |
| LC Amendment | 2023-11-20 |
| Florida Limited Liability | 2023-05-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
