| Entity Name: | BALANCE PSYCHIATRY AND WELLNESS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 07 Jun 2024 (8 months ago) |
| Document Number: | L24000260096 |
| FEI/EIN Number | 99-3657559 |
| Address: | 142 E GORE ST, ORLANDO, FL 32806 UN |
| Mail Address: | 142 E GORE ST, ORLANDO, FL 32806 UN |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063256089 | 2024-06-24 | 2024-07-01 | 142 E GORE ST, ORLANDO, FL, 328061223, US | 142 E GORE ST, ORLANDO, FL, 328061223, US | |||||||||||||||||
|
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| Phone | +1 307-388-0400 |
Authorized person
| Name | BRIANE OLSON |
| Role | OWNER |
| Phone | 3073880400 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| CHERNET, CHAD | Agent | 142 E GORE ST, ORLANDO, FL 32806 |
| Name | Role | Address |
|---|---|---|
| OLSON, BRIANE | Manager | 142 E GORE ST, ORLANDO, FL 32806 UN |
| BRODER, TODD | Manager | 142 E GORE ST, ORLANDO, FL 32806 UN |
| Name | Role | Address |
|---|---|---|
| Chernet, Chad | Authorized Member | 142 E GORE ST, ORLANDO 32806 UN |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-08 |
| Florida Limited Liability | 2024-06-07 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State
