| Entity Name: | JACKSONVILLE'S CHILDREN'S SPEECH CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 17 Aug 2009 (16 years ago) |
| Date of dissolution: | 24 Sep 2010 (14 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2010 (14 years ago) |
| Document Number: | P09000069310 |
| Address: | 14603 BEACH BOULEVARD, SUITE 750, JACKSONVILLE, FL, 32250 |
| Mail Address: | 14603 BEACH BOULEVARD, SUITE 750, JACKSONVILLE, FL, 32250 |
| ZIP code: | 32250 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417180761 | 2009-09-02 | 2009-09-02 | 1415 ATLANTIC BLVD, SUITE B, NEPTUNE BEACH, FL, 322661715, US | 1415 ATLANTIC BLVD, SUITE B, NEPTUNE BEACH, FL, 322661715, US | |||||||||||||||||||||||||
|
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| Phone | +1 904-235-3444 |
| Fax | 9043967403 |
Authorized person
| Name | SAMANTHA K DROOGSMA |
| Role | OWNER |
| Phone | 9042353444 |
Taxonomy
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| License Number | SA9206 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 8913340 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DROOGSMA SAMANTHA | Agent | 14603 BEACH BOULEVARD, JACKSONVILLE, FL, 32250 |
| Name | Role | Address |
|---|---|---|
| DROOGSMA SAMANTHA | Director | 14603 BEACH BOULEVARD #750, JACKSONVILLE, FL, 32250 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| Name | Date |
|---|---|
| Domestic Profit | 2009-08-17 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
