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A SAFE PORT COUNSELING LLC

Company Details

Entity Name: A SAFE PORT COUNSELING LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Company
Status: Active
Date Filed: 03 May 2023 (2 years ago)
Document Number: L23000217961
FEI/EIN Number 92-3937597
Address: 1301 Plantation Island Drive S, Suite 202A, SAINT AUGUSTINE, FL 32080
Mail Address: 4925 ATLANTIC VIEW, SAINT AUGUSTINE, FL 32080
ZIP code: 32080
County: St. Johns
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1982380648 2023-06-26 2024-09-12 4925 ATLANTIC VW, SAINT AUGUSTINE, FL, 320807139, US 4925 ATLANTIC VW, SAINT AUGUSTINE, FL, 320807139, US

Contacts

Phone +1 662-315-8357

Authorized person

Name JUSTIN FORREST DEMENT
Role SOLE MBR
Phone 6623158357

Taxonomy

Taxonomy Code 1041C0700X - Clinical Social Worker
Is Primary Yes

Agent

Name Role Address
DEMENT, JUSTIN F Agent 4925 ATLANTIC VIEW, SAINT AUGUSTINE, FL 32080

Authorized Person

Name Role Address
DEMENT, JUSTIN F Authorized Person 4925 ATLANTIC VIEW, SAINT AUGUSTINE, FL 32080

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-06-03 1301 Plantation Island Drive S, Suite 202A, SAINT AUGUSTINE, FL 32080 No data

Documents

Name Date
ANNUAL REPORT 2024-04-23
Florida Limited Liability 2023-05-03

Date of last update: 10 Feb 2025

Sources: Florida Department of State