| Entity Name: | ALTITUDE HEALTH CORP I, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 31 May 2023 (2 years ago) |
| Document Number: | L23000264427 |
| FEI/EIN Number | 931619267 |
| Address: | 9905 Old St. Augustine Road, Jacksonville, FL, 32257, US |
| Mail Address: | 9905 Old St. Augustine Road, Jacksonville, FL, 32257, US |
| ZIP code: | 32257 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831970029 | 2023-10-12 | 2023-10-12 | 9905 OLD SAINT AUGUSTINE RD STE 400, JACKSONVILLE, FL, 322578856, US | 9905 OLD SAINT AUGUSTINE RD STE 400, JACKSONVILLE, FL, 322578856, US | |||||||||||||||||||||||||||||
|
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| Phone | +1 904-374-8843 |
Authorized person
| Name | ADAM BERK |
| Role | CEO/PARTNER |
| Phone | 9176907556 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 103T00000X - Psychologist |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| Crawford Jacob | Agent | 9905 Old St. Augustine Road, Jacksonville, FL, 32257 |
| Name | Role | Address |
|---|---|---|
| Crawford Jacob | Chief Executive Officer | 9905 Old St. Augustine Road, Jacksonville, FL, 32257 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-10-07 | 9905 Old St. Augustine Road, 400, Jacksonville, FL 32257 | No data |
| CHANGE OF MAILING ADDRESS | 2024-10-07 | 9905 Old St. Augustine Road, 400, Jacksonville, FL 32257 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-10-07 | Crawford, Jacob | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-10-07 | 9905 Old St. Augustine Road, 400, Jacksonville, FL 32257 | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-10-07 |
| ANNUAL REPORT | 2024-02-13 |
| Florida Limited Liability | 2023-05-31 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
