| Entity Name: | SUNSHINE BEHAVIORAL MEDICINE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 30 Oct 2013 (11 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 16 Feb 2018 (7 years ago) |
| Document Number: | P13000089075 |
| FEI/EIN Number | 46-4013560 |
| Address: | 5389 Cotton Street, Graceville, FL, 32440, US |
| Mail Address: | PO BOX 186, Graceville, FL, 32440, US |
| ZIP code: | 32440 |
| County: | Jackson |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598266850 | 2018-02-22 | 2022-01-06 | PO BOX 186, GRACEVILLE, FL, 324400186, US | 5389 COTTON ST, GRACEVILLE, FL, 324401739, US | |||||||||||||||||||
|
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| Phone | +1 850-360-4147 |
| Fax | 8503604068 |
Authorized person
| Name | KIUMARS E. SHAMS |
| Role | PRESIDENT |
| Phone | 8503604147 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| Mosley Nicole | Agent | 5389 Cotton Street, Graceville, FL, 32440 |
| Name | Role | Address |
|---|---|---|
| SHAMS K. | Chief Executive Officer | PO BOX 186, Graceville, FL, 32440 |
| Name | Role | Address |
|---|---|---|
| Mosley Nicole | Secretary | PO BOX 186, Graceville, FL, 32440 |
| Name | Role | Address |
|---|---|---|
| Mosley Nicole | Treasurer | PO BOX 186, Graceville, FL, 32440 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000078972 | JACKSON MENTAL HEALTH CENTER | ACTIVE | 2024-06-28 | 2029-12-31 | No data | P. O. BOX 186, GRACEVILLE, FL, 32440 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-02-10 | 5389 Cotton Street, Graceville, FL 32440 | No data |
| CHANGE OF MAILING ADDRESS | 2021-02-10 | 5389 Cotton Street, Graceville, FL 32440 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-02-10 | 5389 Cotton Street, Graceville, FL 32440 | No data |
| REGISTERED AGENT NAME CHANGED | 2018-02-16 | Mosley, Nicole | No data |
| REINSTATEMENT | 2018-02-16 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| ARTICLES OF CORRECT-ION/NAME CHANGE | 2013-10-31 | SUNSHINE BEHAVIORAL MEDICINE, INC. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-03-30 |
| ANNUAL REPORT | 2022-02-02 |
| ANNUAL REPORT | 2021-02-10 |
| ANNUAL REPORT | 2020-01-22 |
| ANNUAL REPORT | 2019-05-29 |
| REINSTATEMENT | 2018-02-16 |
| Article of Correction/NC | 2013-10-31 |
| Domestic Profit | 2013-10-30 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
