| Entity Name: | BLUEVINE BEHAVIORAL THERAPY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 07 Feb 2024 (a year ago) |
| Document Number: | L24000070027 |
| FEI/EIN Number | 99-1275365 |
| Address: | 427 N MAGNOLIA AVE, ORLANDO, FL 32801 |
| Mail Address: | 14411 WABASSO LOOP, WINTER GARDEN, FL 34787 UN |
| ZIP code: | 32801 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821852617 | 2024-02-12 | 2024-02-12 | 14411 WABASSO LOOP, WINTER GARDEN, FL, 347875797, US | 427 N MAGNOLIA AVE, ORLANDO, FL, 328011524, US | |||||||||||||||
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| Phone | +1 208-695-0098 |
| Phone | +1 407-900-7422 |
Authorized person
| Name | YRALIA DEVEREUX |
| Role | OWNER |
| Phone | 2086950098 |
Taxonomy
| Taxonomy Code | 222Q00000X - Developmental Therapist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DEVEREUX, YRALIA | Agent | 14411 WABASSO LOOP, WINTER GARDEN, FL 34787 |
| Name | Role | Address |
|---|---|---|
| DEVEREUX, YRALIA | Chief Executive Officer | 14411 WABASSO LOOP, WINTER GARDEN, FL 34787 UN |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-02-07 |
Date of last update: 08 Jan 2025
Sources: Florida Department of State
