| Entity Name: | ARCHWAY BEHAVIORAL HEALTH LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 02 May 2024 (9 months ago) |
| Document Number: | L24000207012 |
| Address: | 7100 W CAMINO REAL, BOCA RATON, FL 33433 |
| Mail Address: | 7100 W CAMINO REAL, BOCA RATON, FL 33433 |
| ZIP code: | 33433 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336987122 | 2024-07-17 | 2024-07-17 | 7100 CAMINO REAL, BOCA RATON, FL, 334335510, US | 7100 CAMINO REAL, BOCA RATON, FL, 334335510, US | |||||||||||||
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| Phone | +1 215-478-4065 |
Authorized person
| Name | DR. DENISE JOSEY |
| Role | MEDICAL DIRECTOR |
| Phone | 2154784065 |
Taxonomy
| Taxonomy Code | 261QR0405X - Substance Use Disorder Rehabilitation Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CROALL, RYAN | Agent | 1030 SOUTHEAST 14TH DRIVE, DEERFIELD, FL 33441 |
| Name | Role | Address |
|---|---|---|
| CROALL, RYAN | Manager | 1030 SOUTHEAST 14TH DRIVE, DEERFIELD, FL 33441 |
| MACOMBER, ROSS | Manager | 15 IDA STREET, QUINCY, MA 02169 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-05-02 |
Date of last update: 07 Jan 2025
Sources: Florida Department of State
