| Entity Name: | LIFESTAR CASE MANAGEMENT SERVICES, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 03 May 2011 (14 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 07 Oct 2013 (11 years ago) |
| Document Number: | P11000042818 |
| FEI/EIN Number | 45-2054049 |
| Address: | 3414 W 84th Street, Suite D110, HIALEAH, FL 33018 |
| Mail Address: | 3414 W 84th Street, Suite D110, HIALEAH, FL 33018 |
| ZIP code: | 33018 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174816920 | 2011-05-25 | 2024-07-19 | 3414 W 84TH ST STE D110, HIALEAH, FL, 330184932, US | 3414 W 84TH ST STE D110, HIALEAH, FL, 330184932, US | |||||||||||||||||||||||||
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| Phone | +1 305-825-4320 |
| Fax | 3058258117 |
Authorized person
| Name | MRS. JENNY A BERNAL |
| Role | OWNER |
| Phone | 7863035079 |
Taxonomy
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | Yes |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 004252300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BERNAL, JENNY A | Agent | 3414 W 84th Street, Suite D110, HIALEAH, FL 33018 |
| Name | Role | Address |
|---|---|---|
| BERNAL , JENNY A | Director | 3414 W 84th Street, Suite D110 HIALEAH, FL 33018 |
| Name | Role | Address |
|---|---|---|
| BERNAL , JENNY A | President | 3414 W 84th Street, Suite D110 HIALEAH, FL 33018 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-01-30 | 3414 W 84th Street, Suite D110, HIALEAH, FL 33018 | No data |
| CHANGE OF MAILING ADDRESS | 2023-01-30 | 3414 W 84th Street, Suite D110, HIALEAH, FL 33018 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-01-30 | 3414 W 84th Street, Suite D110, HIALEAH, FL 33018 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-02-13 | BERNAL, JENNY A | No data |
| AMENDMENT | 2013-10-07 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-15 |
| ANNUAL REPORT | 2024-02-03 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-02-07 |
| ANNUAL REPORT | 2021-03-19 |
| ANNUAL REPORT | 2020-03-19 |
| ANNUAL REPORT | 2019-03-15 |
| ANNUAL REPORT | 2018-01-30 |
| ANNUAL REPORT | 2017-02-13 |
| ANNUAL REPORT | 2016-03-28 |
Date of last update: 24 Jan 2025
Sources: Florida Department of State
