| Entity Name: | DAYTONA BEHAVIORAL HEALTH LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 15 Feb 2024 (a year ago) |
| Document Number: | L24000082820 |
| FEI/EIN Number | 99-1431074 |
| Address: | 1635 SOUTH RIDGEWOOD AVE., #201, SOUTH DAYTONA, FL 32119 |
| Mail Address: | 1635 SOUTH RIDGEWOOD AVE., #201, SOUTH DAYTONA, FL 32119 |
| ZIP code: | 32119 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487419396 | 2024-02-20 | 2024-02-20 | 1635 S RIDGEWOOD AVE STE 201, SOUTH DAYTONA, FL, 321198425, US | 1635 S RIDGEWOOD AVE STE 201, SOUTH DAYTONA, FL, 321198425, US | |||||||||||||
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| Phone | +1 772-584-0452 |
Authorized person
| Name | SHANNON MILLER |
| Role | OWNER |
| Phone | 7725840452 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LANKFORD LAW FIRM, PA | Agent | 210 SOUTH BEACH STREET, SUITE 202, DAYTONA BEACH, FL 32114 |
| Name | Role | Address |
|---|---|---|
| MILLER, SHANNON | Authorized Member | 1635 SOUTH RIDGEWOOD AVENUE #201, SOUTH DAYTONA, FL 32119 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-02-15 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State
