| Entity Name: | INSPIRED LIFE BEHAVIORAL HEALTH & COUNSELING, NP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 26 Feb 2024 (a year ago) |
| Document Number: | L24000099172 |
| Address: | 1485 WASSAIL LANE, PUNTA GORDA, FL, 33983, US |
| Mail Address: | 1485 WASSAIL LANE, PUNTA GORDA, FL, 33983, US |
| ZIP code: | 33983 |
| County: | Charlotte |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720835101 | 2024-05-02 | 2024-05-02 | 1485 WASSAIL LN, PUNTA GORDA, FL, 339836028, US | 1485 WASSAIL LN, PUNTA GORDA, FL, 339836028, US | |||||||||||||
|
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| Phone | +1 941-310-1863 |
Authorized person
| Name | DR. MICHELLE LEA ANTANOVICH |
| Role | OWNER |
| Phone | 9413101863 |
Taxonomy
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role |
|---|---|
| ZENBUSINESS INC. | Agent |
| Name | Role | Address |
|---|---|---|
| ANTANOVICH MICHELLE | Authorized Member | 1485 WASSAIL LANE, PUNTA GORDA, FL, 33983 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-02-26 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
