| Entity Name: | EVERGREEN BEHAVIORAL HEALTH INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 03 Nov 2023 (a year ago) |
| Document Number: | N23000013301 |
| FEI/EIN Number | 93-4303251 |
| Address: | 14002 CR 49, LIVE OAK, FL, 32060 |
| Mail Address: | 14002 CR 49, LIVE OAK, FL, 32060 |
| ZIP code: | 32060 |
| County: | Suwannee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932978277 | 2023-12-28 | 2023-12-28 | 1206 SW MAIN BLVD STE 103, LAKE CITY, FL, 320256603, US | 1206 SW MAIN BLVD STE 103, LAKE CITY, FL, 320256603, US | |||||||||||||||
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| Phone | +1 386-487-9979 |
| Fax | 3864879979 |
Authorized person
| Name | JOSHUA MESSER |
| Role | CEO |
| Phone | 3864879979 |
Taxonomy
| Taxonomy Code | 101YA0400X - Addiction (Substance Use Disorder) Counselor |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ADLER & ASSOCIATES INTERNATIONAL | Agent | 25472 89TH DRIVE, O'BRIEN, FL, 32071 |
| Name | Role | Address |
|---|---|---|
| MESSER JOSHUA | Chief Executive Officer | 14002 CR 49, LIVE OAK, FL, 32060 |
| Name | Role | Address |
|---|---|---|
| DOIRON STEPHEN | Director | 1383 ODEN COURT, MIDDLEBURG, FL, 32068 |
| STAWDER KELLI | Director | 668 SW CHESTERFIELD CIRCLE, LAKE CITY, FL, 32024 |
| LLOYD BRIAN | Director | 14002 CR 49, LIVE OAK, FL, 32060 |
| Name | Role | Address |
|---|---|---|
| KIRBY MILES | Secretary | 14002 CR 49, LIVE OAK, FL, 32060 |
| Name | Role | Address |
|---|---|---|
| ADLER & ASSOCIATES INTERNATIONAL | Treasurer | 25472 89TH DRIVE, O'BRIEN, FL, 32071 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-09 |
| Domestic Non-Profit | 2023-11-03 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
