| Entity Name: | BIRD BEHAVIORAL SERVICES INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 29 Oct 2012 (12 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 04 Oct 2015 (9 years ago) |
| Document Number: | P12000090871 |
| FEI/EIN Number | 46-1286743 |
| Address: | 816 PENNSYLVANIA AVE, SAINT CLOUD, FL, 34769, US |
| Mail Address: | 816 PENNSYLVANIA AVE, SAINT CLOUD, FL, 34769, US |
| ZIP code: | 34769 |
| County: | Osceola |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558606210 | 2012-12-06 | 2015-06-02 | 816 PENNSYLVANIA AVE, SAINT CLOUD, FL, 347693371, US | 816 PENNSYLVANIA AVE, SAINT CLOUD, FL, 347693371, US | |||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 321-805-4426 |
| Fax | 4079020019 |
Authorized person
| Name | MS. ALMA T. BIRD |
| Role | AGENCY DIRECTOR |
| Phone | 3218054426 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | MH 5536 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103K00000X - Behavior Analyst |
| License Number | 1-05-2139 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 251B00000X - Case Management Agency |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 010950100 |
| State | FL |
| Issuer | MEDICAID |
| Number | 010369800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Bird Alma | Agent | 816 Pennsylvania Ave, Saint Cloud, FL, 34769 |
| Name | Role | Address |
|---|---|---|
| BIRD ALMA | President | 816 PENNSYLVANIA AVE, SAINT CLOUD, FL, 34769 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000087464 | EXPANDING HORIZONS | ACTIVE | 2023-07-26 | 2028-12-31 | No data | 816 PENNSYLVANIA, SAINT CLOUD, FL, 34769 |
| G13000048856 | EXPANDING HORIZONS | EXPIRED | 2013-05-23 | 2018-12-31 | No data | 816 PENNSYLVANIA AVE, ST CLOUD, FL, 34769 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2022-02-09 | 816 Pennsylvania Ave, Saint Cloud, FL 34769 | No data |
| REINSTATEMENT | 2015-10-04 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2015-10-04 | Bird, Alma | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-05-14 | 816 PENNSYLVANIA AVE, SAINT CLOUD, FL 34769 | No data |
| CHANGE OF MAILING ADDRESS | 2013-05-14 | 816 PENNSYLVANIA AVE, SAINT CLOUD, FL 34769 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-05 |
| ANNUAL REPORT | 2022-02-09 |
| AMENDED ANNUAL REPORT | 2021-10-27 |
| ANNUAL REPORT | 2021-04-01 |
| ANNUAL REPORT | 2020-03-19 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-02-22 |
| AMENDED ANNUAL REPORT | 2017-06-08 |
| ANNUAL REPORT | 2017-02-10 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 4625788108 | 2020-07-16 | 0455 | PPP | 816 Pennsylvania Avenue, St. Cloud, FL, 34769 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Feb 2025
Sources: Florida Department of State
