| Entity Name: | VERO BEACH ABA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 29 Jul 2024 (6 months ago) |
| Document Number: | L24000334792 |
| FEI/EIN Number | 99-4291581 |
| Address: | 1985 FLORA LANE, VERO BEACH, FL 32966 |
| Mail Address: | 1985 FLORA LANE, VERO BEACH, FL 32966 |
| ZIP code: | 32966 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750103487 | 2024-10-24 | 2024-10-24 | 1985 FLORA LN, VERO BEACH, FL, 329661033, US | 1985 FLORA LN, VERO BEACH, FL, 329661033, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 772-291-6654 |
Authorized person
| Name | JENNIFER DENISE BORDA |
| Role | SOLE MEMBER |
| Phone | 7722916654 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1730559808 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BORDA, JENNIFER | Agent | 1985 FLORA LANE, VERO BEACH, FL 32966 |
| Name | Role | Address |
|---|---|---|
| BORDA, JENNIFER | Authorized Representative | 1985 FLORA LANE, VERO BEACH, FL 32966 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-07 |
| Florida Limited Liability | 2024-07-29 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State
