| Entity Name: | A WILLING NOBLE SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 May 2023 (2 years ago) |
| Document Number: | L23000225871 |
| FEI/EIN Number | 92-3982835 |
| Address: | 2151 SW BARTHEL STREET, PORT SAINT LUCIE, FL, 34984, US |
| Mail Address: | 2151 SW BARTHEL STREET, PORT SAINT LUCIE, FL, 34984, US |
| ZIP code: | 34984 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124719604 | 2023-05-16 | 2023-05-16 | 2151 SW BARTHEL ST, PORT SAINT LUCIE, FL, 349844301, US | 2151 SW BARTHEL ST, PORT SAINT LUCIE, FL, 349844301, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 561-755-1797 |
| Fax | 4809061475 |
Authorized person
| Name | MRS. KATHERINE NICOLE WILLINGHAM |
| Role | APRN |
| Phone | 5617551797 |
Taxonomy
| Taxonomy Code | 251C00000X - Developmentally Disabled Services Day Training Agency |
| Is Primary | No |
| Taxonomy Code | 261QA0600X - Adult Day Care Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QD1600X - Developmental Disabilities Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 315P00000X - Intellectual Disabilities Intermediate Care Facility |
| Is Primary | No |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | Yes |
| Taxonomy Code | 385H00000X - Respite Care |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| WILLINGHAM KATHERINE N | Agent | 2151 SW BARTHEL STREET, PORT SAINT LUCIE, FL, 34984 |
| Name | Role | Address |
|---|---|---|
| WILLINGHAM KATHERINE N | Authorized Member | 2151 SW BARTHEL STREET, PORT SAINT LUCIE, FL, 34984 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| Florida Limited Liability | 2023-05-01 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
