| Entity Name: | ELEMENTAL BEHAVIORAL INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 29 Jul 2014 (11 years ago) |
| Document Number: | P14000063545 |
| FEI/EIN Number | 47-1460032 |
| Address: | 10250 SW 56TH STREET, A-102, MIAMI, FL, 33165 |
| Mail Address: | 10250 SW 56TH STREET, A-102, MIAMI, FL, 33165 |
| ZIP code: | 33165 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306255427 | 2014-08-04 | 2022-03-22 | 10250 SW 56TH ST STE A102, MIAMI, FL, 331657064, US | 10250 SW 56TH ST STE A102, MIAMI, FL, 33165, US | |||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||
| Phone | +1 786-477-4431 |
| Fax | 7864774377 |
| Phone | +1 786-306-1401 |
Authorized person
| Name | DR. MANUEL AUGUSTO MELENDEZ |
| Role | OWNER |
| Phone | 3059269124 |
Taxonomy
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 012847400 |
| State | FL |
| Issuer | EXEMPT COMMUNITY MENTAL HEALTH CENTER |
| Number | 15755 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MELENDEZ MANUEL | Agent | 10250 SW 56TH STREET, MIAMI, FL, 33165 |
| Name | Role | Address |
|---|---|---|
| MELENDEZ MANUEL | President | 10250 SW 56TH STREET, MIAMI, FL, 33165 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2017-03-10 | 10250 SW 56TH STREET, A-102, MIAMI, FL 33165 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-28 |
| ANNUAL REPORT | 2023-03-21 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-03-14 |
| ANNUAL REPORT | 2020-06-08 |
| ANNUAL REPORT | 2019-04-05 |
| ANNUAL REPORT | 2018-04-28 |
| ANNUAL REPORT | 2017-03-10 |
| AMENDED ANNUAL REPORT | 2016-10-28 |
| ANNUAL REPORT | 2016-02-04 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
