| Entity Name: | COMMUNITY MENTAL HEALTH AND WELLNESS CENTER OF DORAL INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Not For Profit Corporation |
| Status: | Inactive |
| Date Filed: | 09 Jun 2017 (8 years ago) |
| Date of dissolution: | 10 Aug 2018 (7 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 10 Aug 2018 (7 years ago) |
| Document Number: | N17000006221 |
| FEI/EIN Number | 82-1809710 |
| Address: | 9300 NW 25 ST STE 106, DORAL, FL 33172 |
| Mail Address: | 9300 NW 25 ST STE 106, DORAL, FL 33172 FL |
| ZIP code: | 33172 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1740702406 | 2017-07-13 | 2018-03-27 | 9300 NW 25TH ST STE 106, DORAL, FL, 331721506, US | 9300 NW 25TH ST STE 106, DORAL, FL, 331721506, US | |||||||||||||||||||||||||||||||
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| Phone | +1 786-320-4603 |
Authorized person
| Name | JESSICA RODRIGUEZ |
| Role | PRESIDENT |
| Phone | 7864900974 |
Taxonomy
| Taxonomy Code | 102L00000X - Psychoanalyst |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 261QC1500X - Community Health Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AHCA |
| Number | HCC12703 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ, JESSICA | Agent | 9300 NW 25 ST STE 106, DORAL, FL 33172 |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ, JESSICA | President | 9300 NW 25TH STREET, SUITE 106 DORAL, FL 33172 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2018-08-10 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-05-31 | 9300 NW 25 ST STE 106, DORAL, FL 33172 | No data |
| CHANGE OF MAILING ADDRESS | 2018-05-31 | 9300 NW 25 ST STE 106, DORAL, FL 33172 | No data |
| REGISTERED AGENT NAME CHANGED | 2018-05-31 | RODRIGUEZ, JESSICA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-05-31 | 9300 NW 25 ST STE 106, DORAL, FL 33172 | No data |
| ARTICLES OF CORRECT-ION/NAME CHANGE | 2017-07-06 | COMMUNITY MENTAL HEALTH AND WELLNESS CENTER OF DORAL INC | No data |
| Name | Date |
|---|---|
| Reg. Agent Change | 2018-05-31 |
| ANNUAL REPORT | 2018-02-01 |
| Article of Correction/NC | 2017-07-06 |
| Domestic Non-Profit | 2017-06-09 |
Date of last update: 18 Feb 2025
Sources: Florida Department of State
