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LIFESTREAM BEHAVIORAL HEALTH, LLC - Florida Company Profile

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Company Details

Entity Name: LIFESTREAM BEHAVIORAL HEALTH, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 19 Mar 2025 (5 months ago)
Document Number: L25000133941
Address: 1839 CENTRAL AVE, ST PETERSBURG, FL, 33713, US
Mail Address: 1839 CENTRAL AVE, SAINT PETERSBURG, FL, 33713, US
ZIP code: 33713
City: Saint Petersburg
County: Pinellas
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
HAJEK MICHAEL Agent 1839 CENTRAL AVE, ST PETERSBURG, FL, 33713
SHEEHAN JOHN Manager 1839 CENTRAL AVE, SAINT PETERSBURG, FL, 33713

National Provider Identifier

NPI Number:
1841083912
Certification Date:
2025-05-22

Authorized Person:

Name:
WILLIAM FULLER
Role:
CHIEF OPERATING OFFICER
Phone:

Taxonomy:

Selected Taxonomy:
2084P0800X - Psychiatry Physician
Is Primary:
Yes

Contacts:

Fax:
7278201060

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Date of last update: 01 Aug 2025

Sources: Florida Department of State