| Entity Name: | NUTEGRA MENTAL HEALTH AND NUTRITION, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 26 Apr 2002 (23 years ago) |
| Document Number: | P02000047298 |
| FEI/EIN Number | 030445105 |
| Address: | 260 NW Peacock Blvd. Suite 102, Port St. Lucie, FL, 34986, US |
| Mail Address: | 1751 Hunter Creek Dr., Punta Gorda, FL, 33982, US |
| ZIP code: | 34986 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801066873 | 2008-03-06 | 2024-03-28 | 1751 HUNTER CREEK DR, PUNTA GORDA, FL, 339821135, US | 260 NW PEACOCK BLVD STE 102, PORT ST LUCIE, FL, 349862349, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 941-740-0193 |
| Fax | 9412575550 |
| Phone | +1 941-787-3525 |
Authorized person
| Name | CHRISANNA G WRIGHT |
| Role | PRESIDENT |
| Phone | 9417873525 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
| Taxonomy Code | 133VN1006X - Metabolic Nutrition Registered Dietitian |
| License Number | ND 2695 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BCBS FL |
| Number | N0250 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Wright CHRISANNA K | Agent | 1751 Hunter Creek Dr, Punta Gorda, FL, 33982 |
| Name | Role | Address |
|---|---|---|
| Wright CHRISANNA K | President | 1751 Hunter Creek Dr, Punta Gorda, FL, 33982 |
| Name | Role | Address |
|---|---|---|
| Wright Terrance M | Secretary | 1751 Hunter Creek Dr, PUNTA GORDA, FL, 33982 |
| Name | Role | Address |
|---|---|---|
| Wright Terrance M | Vice President | 1751 Hunter Creek Dr, PUNTA GORDA, FL, 33982 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000107582 | NUTEGRA MEDICAL NUTRITION THERAPY | EXPIRED | 2017-09-28 | 2022-12-31 | No data | PO BOX 511283, PUNTA GORDA, FL, 33951 |
| G11000069685 | NUTEGRA HEALTHY WEIGHT CENTER | EXPIRED | 2011-07-12 | 2016-12-31 | No data | 20020 VETERANS BLVD. STE 12, PORT CHARLOTTE, FL, 33954 |
| G08339700035 | THE COUNSELING SERVICE CENTER | EXPIRED | 2008-12-04 | 2013-12-31 | No data | 20020 VETERANS BLVD, SUITE 12, PORT CHARLOTTE, FL, 33954 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2012-11-26 | No data | No data |
| AMENDMENT AND NAME CHANGE | 2009-01-13 | NUTEGRA MENTAL HEALTH AND NUTRITION, INC. | No data |
| NAME CHANGE AMENDMENT | 2007-11-19 | NUTEGRA NUTRITION SERVICES, INC. | No data |
Date of last update: 03 Jan 2025
Sources: Florida Department of State
