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TRANSFORMING MINDS AND LIVES BEHAVIORAL RESOURCES, LLC - Florida Company Profile

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Company Details

Entity Name: TRANSFORMING MINDS AND LIVES BEHAVIORAL RESOURCES, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 18 Dec 2024 (8 months ago)
Document Number: L24000524146
FEI/EIN Number 33-2460743
Address: 3930 NW 167TH STREET, MIAMI GARDENS, FL, 33054, US
Mail Address: 3930 NW 167TH STREET, MIAMI GARDENS, FL, 33054
ZIP code: 33054
City: Opa Locka
County: Miami-Dade
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
THEOC PHONIA President 3930 NW 167TH STREET, MIAMI GARDENS, FL, 33054
THEOC PHONIA Agent 3930 NW 167TH STREET, MIAMI GARDENS, FL, 33054

National Provider Identifier

NPI Number:
1013725175
Certification Date:
2024-12-20

Authorized Person:

Name:
PHONIA THEOC
Role:
MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
101YM0800X - Mental Health Counselor
Is Primary:
Yes

Contacts:

Documents

Name Date
Florida Limited Liability 2024-12-18

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Date of last update: 02 Aug 2025

Sources: Florida Department of State