| Entity Name: | UPPER ROOM COUNSELING CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 10 Aug 2006 (19 years ago) |
| Date of dissolution: | 09 Feb 2017 (8 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 09 Feb 2017 (8 years ago) |
| Document Number: | P06000104874 |
| FEI/EIN Number | 030602017 |
| Address: | 3420 US HWY 27-441, FRUITLAND PARK, FL, 34731 |
| Mail Address: | 3420 US HWY 27-441, FRUITLAND PARK, FL, 34731 |
| ZIP code: | 34731 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134439235 | 2010-10-07 | 2012-07-31 | 3420 HWY 441/27, FRUITLAND PARK, FL, 347314474, US | 3420 HWY 27/441, FRUITLAND PARK, FL, 347314474, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 352-435-4631 |
| Fax | 3524354632 |
Authorized person
| Name | MR. JERRY FRANKLIN PHILLIPS |
| Role | DIRECTOR OF COUNSELING |
| Phone | 3524354631 |
Taxonomy
| Taxonomy Code | 101Y00000X - Counselor |
| License Number | MH-4358 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 101YA0400X - Addiction (Substance Use Disorder) Counselor |
| License Number | MH-4358 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | MH-4358 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 101YP1600X - Pastoral Counselor |
| License Number | MH-4358 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 101YP2500X - Professional Counselor |
| License Number | MH-4358 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 102L00000X - Psychoanalyst |
| License Number | MH-4358 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 106H00000X - Marriage & Family Therapist |
| License Number | MH-4358 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| PHILLIPS JERRY F | Agent | 3420 US HWY 27-441, FRUITLAND PARK, FL, 34731 |
| Name | Role | Address |
|---|---|---|
| PHILLIPS JERRY F | President | 3420 US HWY 27-441, FRUITLAND PARK, FL, 34731 |
| Name | Role | Address |
|---|---|---|
| Phillips Rebekah M | Vice President | 3420 US HWY 27-441, FRUITLAND PARK, FL, 34731 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2017-02-09 | No data | No data |
| AMENDMENT | 2012-08-03 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-08-03 | 3420 US HWY 27-441, FRUITLAND PARK, FL 34731 | No data |
| CHANGE OF MAILING ADDRESS | 2012-08-03 | 3420 US HWY 27-441, FRUITLAND PARK, FL 34731 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-08-03 | 3420 US HWY 27-441, FRUITLAND PARK, FL 34731 | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2016-07-20 |
| ANNUAL REPORT | 2016-04-11 |
| ANNUAL REPORT | 2015-03-09 |
| ANNUAL REPORT | 2014-03-20 |
| ANNUAL REPORT | 2013-03-18 |
| Amendment | 2012-08-03 |
| ANNUAL REPORT | 2012-05-15 |
| ANNUAL REPORT | 2011-03-17 |
| ANNUAL REPORT | 2010-03-02 |
| ANNUAL REPORT | 2009-04-29 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
