| Entity Name: | HAVENNEXUS FAMILY PSYCHIATRY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 20 Dec 2023 (a year ago) |
| Document Number: | L23000558979 |
| Address: | 50 Leanni Way, Unit B1, Palm Coast, FL 32137 |
| Mail Address: | 50 Leanni Way, Unit B1, Palm Coast, FL 32137 |
| ZIP code: | 32137 |
| County: | Flagler |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750147971 | 2024-02-26 | 2024-06-21 | 210 S BEACH ST STE 202, DAYTONA BEACH, FL, 321144430, US | 50 LEANNI WAY UNIT B1, PALM COAST, FL, 321374754, US | |||||||||||||
|
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| Phone | +1 386-334-5657 |
Authorized person
| Name | TOLULOPE ODUYEJO WILLIAMS |
| Role | OWNER |
| Phone | 3863345657 |
Taxonomy
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ODUYEJO WILLIAMS, TOLULOPE | Agent | 210 SOUTH BEACH STREET, STE 202, DAYTONA BEACH, FL 32114 |
| Name | Role | Address |
|---|---|---|
| ODUYEJO WILLIAMS, TOLULOPE | Authorized Member | 210 SOUTH BEACH STREET STE 202, STE 202, FL 32114 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-06-17 | 50 Leanni Way, Unit B1, Palm Coast, FL 32137 | No data |
| CHANGE OF MAILING ADDRESS | 2024-06-17 | 50 Leanni Way, Unit B1, Palm Coast, FL 32137 | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2023-12-20 |
Date of last update: 08 Jan 2025
Sources: Florida Department of State
