| Entity Name: | KETAMINE WELLNESS CENTERS JACKSONVILLE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 12 Nov 2020 (4 years ago) |
| Date of dissolution: | 13 Dec 2024 (4 months ago) |
| Last Event: | WITHDRAWAL |
| Event Date Filed: | 13 Dec 2024 (4 months ago) |
| Document Number: | M20000010375 |
| FEI/EIN Number |
85-3704829
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 3753-2 CARDINAL POINT DR, JACKSONVILLE, FL, 32257, US |
| ZIP code: | 32257 |
| County: | Duval |
| Place of Formation: | ARIZONA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063016988 | 2020-11-23 | 2020-11-23 | 113 W HOOVER AVE STE 101, MESA, AZ, 852105214, US | 3753-2 CARDINAL POINT DR, JACKSONVILLE, FL, 322575582, US | |||||||||||||||
|
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| Phone | +1 855-538-9355 |
| Fax | 8445389355 |
Authorized person
| Name | MS. ANITA JERGER |
| Role | EXECUTIVE ASSISTANT |
| Phone | 8555389355 |
Taxonomy
| Taxonomy Code | 207LP2900X - Pain Medicine (Anesthesiology) Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| NICHOLSON JULIE | Manager | 491 N 159 PL, GILBERT, AZ, 85234 |
| NICHOLAS KEVIN | Manager | 491 N 159 PL, GILBERT, AZ, 85234 |
| BLACK BARBARA | Agent | 3753-2 CARDINAL POINT DR, JACKSONVILLE, FL, 32257 |
| KETAMINE WELLNESS CENTERS ARIZONA | Member | 491 N 159 PL, GILBERT, AZ, 85234 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| WITHDRAWAL | 2024-12-13 | - | - |
| REVOKED FOR ANNUAL REPORT | 2024-09-27 | - | - |
| Name | Date |
|---|---|
| WITHDRAWAL | 2024-12-13 |
| AMENDED ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2023-01-18 |
| ANNUAL REPORT | 2022-02-01 |
| ANNUAL REPORT | 2021-02-25 |
| Foreign Limited | 2020-11-12 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
