| Entity Name: | BROKEN ROADS COUNSELING LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 15 Feb 2024 (a year ago) |
| Document Number: | L24000081706 |
| Address: | 3519 168TH STREET, WELLBORN, FL, 32094 |
| Mail Address: | 3519 168TH STREET, WELLBORN, FL, 32094 |
| ZIP code: | 32094 |
| County: | Suwannee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487494191 | 2024-05-30 | 2024-05-30 | 3519 168TH ST, WELLBORN, FL, 320943017, US | 3519 168TH ST, WELLBORN, FL, 320943017, US | |||||||||||||
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| Phone | +1 386-249-5976 |
Authorized person
| Name | STACY BRANDON |
| Role | OWNER |
| Phone | 3862495976 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BRANDON STACY A | Agent | 3519 168TH STREET, WELLBORN, FL, 32094 |
| Name | Role | Address |
|---|---|---|
| BRANDON STACY A | Authorized Member | 3519 168TH STREET, WELLBORN, FL, 32094 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-02-15 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
