| Entity Name: | CHILDREN'S THERAPY NETWORK, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 28 Mar 2005 (20 years ago) |
| Date of dissolution: | 18 Sep 2013 (11 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 18 Sep 2013 (11 years ago) |
| Document Number: | P05000046148 |
| FEI/EIN Number | 20-2576779 |
| Address: | 1604 S. RIDGEWOOD AVE., EDGEWATER, FL 32132 |
| Mail Address: | 1604 S. RIDGEWOOD AVE., EDGEWATER, FL 32132 |
| ZIP code: | 32132 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457384505 | 2006-07-09 | 2012-09-04 | 1604 S RIDGEWOOD AVE, EDGEWATER, FL, 321323612, US | 1604 S RIDGEWOOD AVE, EDGEWATER, FL, 321323612, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 386-428-4805 |
| Fax | 8664575239 |
Authorized person
| Name | GINA JOHNSON |
| Role | PRESIDENT |
| Phone | 3864284805 |
Taxonomy
| Taxonomy Code | 224Z00000X - Occupational Therapy Assistant |
| Is Primary | No |
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PT14998 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 2251P0200X - Pediatric Physical Therapist |
| Is Primary | No |
| Taxonomy Code | 225200000X - Physical Therapy Assistant |
| Is Primary | No |
| Taxonomy Code | 225X00000X - Occupational Therapist |
| Is Primary | Yes |
| Taxonomy Code | 225XP0200X - Pediatric Occupational Therapist |
| License Number | OT12846 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 890529100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| JOHNSON, GINA | Agent | 316 TWO OAKS DRIVE, EDGEWATER, FL 32141 |
| Name | Role | Address |
|---|---|---|
| JOHNSON, GINA | President | 316 TWO OAKS DRIVE, EDGEWATER, FL 32141 |
| Name | Role | Address |
|---|---|---|
| JOHNSON, GINA | Vice President | 316 TWO OAKS DRIVE, EDGEWATER, FL 32141 |
| Name | Role | Address |
|---|---|---|
| JOHNSON, GINA | Secretary | 316 TWO OAKS DRIVE, EDGEWATER, FL 32141 |
| Name | Role | Address |
|---|---|---|
| JOHNSON, GINA | Treasurer | 316 TWO OAKS DRIVE, EDGEWATER, FL 32141 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2013-09-18 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-09-04 | 1604 S. RIDGEWOOD AVE., EDGEWATER, FL 32132 | No data |
| CHANGE OF MAILING ADDRESS | 2012-09-04 | 1604 S. RIDGEWOOD AVE., EDGEWATER, FL 32132 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2013-09-18 |
| ANNUAL REPORT | 2013-03-19 |
| ANNUAL REPORT | 2012-03-19 |
| ANNUAL REPORT | 2011-03-17 |
| ANNUAL REPORT | 2010-03-29 |
| ANNUAL REPORT | 2009-03-12 |
| ANNUAL REPORT | 2008-03-10 |
| ANNUAL REPORT | 2007-04-14 |
| ANNUAL REPORT | 2006-04-03 |
| Off/Dir Resignation | 2006-02-09 |
Date of last update: 04 Jan 2025
Sources: Florida Department of State
