| Entity Name: | ACHIEVE PEDIATRIC THERAPY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 19 Jun 2007 (18 years ago) |
| Document Number: | P07000071223 |
| FEI/EIN Number | 611532540 |
| Address: | 11602 Lake Underhill Road, Suite 129, ORLANDO, FL, 32825, US |
| Mail Address: | 11602 Lake Underhill Road, Suite 129, ORLANDO, FL, 32825, US |
| ZIP code: | 32825 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174280325 | 2021-11-23 | 2021-11-23 | 11602 LAKE UNDERHILL ROAD,, SUITE 129, ORLANDO, FL, 32825, US | 11602 LAKE UNDERHILL ROAD,, SUITE 129, ORLANDO, FL, 32825, US | |||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||
| Phone | +1 407-277-5400 |
| Fax | 3212814942 |
Authorized person
| Name | HEATHER B GRAY |
| Role | OWNER/OCCUPATIONAL THERAPIST |
| Phone | 4072775400 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | Yes |
| Taxonomy Code | 106E00000X - Assistant Behavior Analyst |
| Is Primary | No |
| Taxonomy Code | 106S00000X - Behavior Technician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 024402800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GRAY HEATHER B | Agent | 11602 Lake Underhill Road, ORLANDO, FL, 32825 |
| Name | Role | Address |
|---|---|---|
| GRAY HEATHER B | Chief Executive Officer | 11602 Lake Underhill Road, ORLANDO, FL, 32825 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2015-01-09 | 11602 Lake Underhill Road, Suite 129, ORLANDO, FL 32825 | No data |
| CHANGE OF MAILING ADDRESS | 2015-01-09 | 11602 Lake Underhill Road, Suite 129, ORLANDO, FL 32825 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-01-09 | 11602 Lake Underhill Road, Suite 129, ORLANDO, FL 32825 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-04 |
| ANNUAL REPORT | 2023-01-17 |
| ANNUAL REPORT | 2022-01-05 |
| ANNUAL REPORT | 2021-03-15 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-02-06 |
| ANNUAL REPORT | 2018-01-10 |
| ANNUAL REPORT | 2017-01-09 |
| ANNUAL REPORT | 2016-01-21 |
| ANNUAL REPORT | 2015-01-09 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
