| Entity Name: | JENNIFER A. LEIGH, M.S. CCC-SLP, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 Mar 2001 (24 years ago) |
| Document Number: | P01000033112 |
| FEI/EIN Number | 593712121 |
| Address: | 7243 US HWY 301 S, STE A, Riverview, FL, 33578-8399, US |
| Mail Address: | 9931 Allen Rd, Lithia, FL, 33547, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1235709759 | 2021-06-28 | 2021-06-28 | 7243 US HIGHWAY 301 S STE A, RIVERVIEW, FL, 335788399, US | 7243 US HIGHWAY 301 S STE A, RIVERVIEW, FL, 335788399, US | |||||||||||||||||||||
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| Phone | +1 813-663-9828 |
| Fax | 8889656670 |
Authorized person
| Name | BETHANY LEAVITT |
| Role | OFFICE MANAGER |
| Phone | 8136639828 |
Taxonomy
| Taxonomy Code | 252Y00000X - Early Intervention Provider Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 003986900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LEIGH JENNIFER A | Agent | 9931 ALLEN ROAD, LITHIA, FL, 33547 |
| Name | Role | Address |
|---|---|---|
| LEIGH JENNIFER A | Treasurer | 7243 US Hwy 301 S, RIVERVIEW, FL, 335788399 |
| Name | Role | Address |
|---|---|---|
| LEIGH JENNIFER A | Director | 7243 US Hwy 301 S, RIVERVIEW, FL, 335788399 |
| Name | Role | Address |
|---|---|---|
| LEIGH JENNIFER A | President | 7243 US Hwy 301 S, RIVERVIEW, FL, 335788399 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G10000015602 | TOTAL THERAPY | ACTIVE | 2010-02-17 | 2025-12-31 | No data | 9931 ALLEN ROAD, LITHIA, FL, 33547 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2017-01-20 | 7243 US HWY 301 S, STE A, Riverview, FL 33578-8399 | No data |
| CHANGE OF MAILING ADDRESS | 2017-01-20 | 7243 US HWY 301 S, STE A, Riverview, FL 33578-8399 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-01-20 | 9931 ALLEN ROAD, LITHIA, FL 33547 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-15 |
| ANNUAL REPORT | 2024-01-17 |
| ANNUAL REPORT | 2023-01-18 |
| ANNUAL REPORT | 2022-01-11 |
| ANNUAL REPORT | 2021-01-22 |
| ANNUAL REPORT | 2020-01-06 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-01-09 |
| ANNUAL REPORT | 2017-01-20 |
| ANNUAL REPORT | 2016-01-11 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2049857808 | 2020-05-22 | 0455 | PPP | 7243 US HIGHWAY 301 S STE A, RIVERVIEW, FL, 33578 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Feb 2025
Sources: Florida Department of State
