| Entity Name: | DAGNAN BEHAVIORAL CONSULTANTS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 26 Jul 2005 (20 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 27 Oct 2010 (14 years ago) |
| Document Number: | P05000104322 |
| FEI/EIN Number | 743149605 |
| Address: | 1937 GRACE AVE, FORT MYERS, FL, 33902, US |
| Mail Address: | 1937 GRACE AVE, FORT MYERS, FL, 33902, US |
| ZIP code: | 33902 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194020172 | 2011-01-21 | 2011-01-21 | 13332 QUEEN PALM RUN, N FT MYERS, FL, 339035294, US | 13332 QUEEN PALM RUN, N FT MYERS, FL, 339035294, US | |||||||||||||||||||||||||||||
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| Phone | +1 239-822-6886 |
Authorized person
| Name | MS. JAYLENE DAGNAN |
| Role | OWNER |
| Phone | 2398226886 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| License Number | 1010546 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 687169198 |
| State | FL |
| Issuer | MEDICAID |
| Number | 687169196 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DAGNAN JAYLENE | Agent | 13332 QUEEN PALM RUN, FT MYERS, FL, 33903 |
| Name | Role | Address |
|---|---|---|
| DAGNAN JAYLENE | Director | 13332 QUEEN PALM RUN NORTH, FORT MYERS, FL, 33903 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2010-10-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-10-27 | 1937 GRACE AVE, FORT MYERS, FL 33902 | No data |
| CHANGE OF MAILING ADDRESS | 2010-10-27 | 1937 GRACE AVE, FORT MYERS, FL 33902 | No data |
| REGISTERED AGENT NAME CHANGED | 2010-10-27 | DAGNAN, JAYLENE | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-10-27 | 13332 QUEEN PALM RUN, FT MYERS, FL 33903 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-11 |
| ANNUAL REPORT | 2024-02-03 |
| ANNUAL REPORT | 2023-03-09 |
| ANNUAL REPORT | 2022-03-04 |
| ANNUAL REPORT | 2021-01-27 |
| ANNUAL REPORT | 2020-03-13 |
| ANNUAL REPORT | 2019-04-14 |
| ANNUAL REPORT | 2018-03-22 |
| ANNUAL REPORT | 2017-02-02 |
| ANNUAL REPORT | 2016-03-02 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
