| Entity Name: | REVIVE MENTAL HEALTH CENTER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 02 Jul 2024 (7 months ago) |
| Document Number: | L24000298399 |
| Address: | 900 WEST 49TH STREET, SUITE B 001, HIALEAH, FL 33012 |
| Mail Address: | 900 WEST 49TH STREET, SUITE B 001, HIALEAH, FL 33012 |
| ZIP code: | 33012 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790521375 | 2024-07-03 | 2024-07-03 | 900 W 49TH ST STE B001, HIALEAH, FL, 330123402, US | 900 W 49TH ST STE B001, HIALEAH, FL, 330123402, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 786-663-2822 |
Authorized person
| Name | CLAUDIA VIELMA FLORES |
| Role | OWNER |
| Phone | 7866632822 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CODECIDO, ALEXANDRA | Agent | 10465 SW 26TH TERRACE, MIAMI, FL 33165 |
| Name | Role | Address |
|---|---|---|
| VIELMA FLORES, CLAUDIA | Manager | 10790 N KENDALL DRIVE, APT C28, MIAMI, FL 33176 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-07-02 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State
