| Entity Name: | BAYTREE BEHAVIORAL HEALTH PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 01 Dec 2003 (21 years ago) |
| Document Number: | P03000142646 |
| FEI/EIN Number | 200440872 |
| Address: | 1370 BEDFORD DR, #106, MELBOURNE, FL, 32940, US |
| Mail Address: | 1370 BEDFORD DR, #106, MELBOURNE, FL, 32940, US |
| ZIP code: | 32940 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447302633 | 2007-01-17 | 2012-12-13 | 1370 BEDFORD DR, SUITE 106, MELBOURNE, FL, 329401993, US | 1370 BEDFORD DR, SUITE 106, MELBOURNE, FL, 329401993, US | |||||||||||||||||||
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| Phone | +1 321-253-8887 |
| Fax | 3212538878 |
Authorized person
| Name | DR. L. SCOTT FAIRCHILD |
| Role | PRESIDENT |
| Phone | 3212538887 |
Taxonomy
| Taxonomy Code | 103T00000X - Psychologist |
| License Number | PY 6051 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| WALDEN JOSEPH | Agent | 1370 BEDFORD DR, MELBOURNE, FL, 32940 |
| Name | Role | Address |
|---|---|---|
| Walden Joseph Dr. | President | 1370 Bedford Drive, MELBOURNE, FL, 32940 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2022-11-21 | WALDEN, JOSEPH | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-11-21 | 1370 BEDFORD DR, #106, MELBOURNE, FL 32940 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2005-01-21 | 1370 BEDFORD DR, #106, MELBOURNE, FL 32940 | No data |
| CHANGE OF MAILING ADDRESS | 2005-01-21 | 1370 BEDFORD DR, #106, MELBOURNE, FL 32940 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-01 |
| ANNUAL REPORT | 2023-02-02 |
| Reg. Agent Change | 2022-11-21 |
| ANNUAL REPORT | 2022-02-12 |
| ANNUAL REPORT | 2021-02-16 |
| ANNUAL REPORT | 2020-01-21 |
| ANNUAL REPORT | 2019-02-15 |
| ANNUAL REPORT | 2018-02-22 |
| ANNUAL REPORT | 2017-03-15 |
| ANNUAL REPORT | 2016-03-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
