| Entity Name: | ALLIANCE AWARENESS CENTER, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 15 Aug 2014 (10 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | P14000068167 |
| FEI/EIN Number | 47-1385214 |
| Address: | 390 North Orange Ave, ORLANDO, FL, 32801, US |
| Mail Address: | 8908 State Road 535, ORLANDO, FL, 32836, US |
| ZIP code: | 32801 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669836995 | 2016-04-13 | 2016-04-13 | 390 N ORANGE AVE, SUITE 2300, ORLANDO, FL, 328011640, US | 390 N ORANGE AVE, SUITE 2300, ORLANDO, FL, 328011640, US | |||||||||||||||||||||||
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| Phone | +1 877-646-3374 |
| Fax | 3212349267 |
Authorized person
| Name | MR. THEODORE ODEM JR. |
| Role | CEO/OWNER/FOUNDER |
| Phone | 8776463374 |
Taxonomy
| Taxonomy Code | 261QM0855X - Adolescent and Children Mental Health Clinic/Center |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1760891493 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ODEM THEODORE | Agent | 8908 State Road 535, ORLANDO, FL, 32836 |
| Name | Role | Address |
|---|---|---|
| ODEM THEODORE | Chief Executive Officer | 8908 State Road 535, ORLANDO, FL, 32836 |
| Name | Role | Address |
|---|---|---|
| ODEM THEODORE | President | 8908 State Road 535, ORLANDO, FL, 32836 |
| Name | Role | Address |
|---|---|---|
| RENTZ JAMES | BM | 618 CENTER ST., JACKSONVILLE, FL, 32205 |
| HANSBERRY PHYLLIS | BM | 1499 SILVER BELL LANE, FLEMING ISLAND, FL, 32003 |
| RAY SHARON | BM | 1924 TALLADEGA RD, JACKSONVILLE, FL, 32209 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-10-11 | 390 North Orange Ave, 2300, ORLANDO, FL 32801 | No data |
| REINSTATEMENT | 2016-10-11 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-09-29 | 8908 State Road 535, ORLANDO, FL 32836 | No data |
| REINSTATEMENT | 2015-09-29 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2015-09-29 | 390 North Orange Ave, 2300, ORLANDO, FL 32801 | No data |
| REGISTERED AGENT NAME CHANGED | 2015-09-29 | ODEM, THEODORE | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2016-10-11 |
| REINSTATEMENT | 2015-09-29 |
| Domestic Profit | 2014-08-15 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
