| Entity Name: | LIGHT OF HOPE BEHAVIOR THERAPY, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 27 Jan 2015 (10 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 16 Mar 2020 (5 years ago) |
| Document Number: | P15000008604 |
| FEI/EIN Number | 47-2920114 |
| Address: | 15190 SW 136TH ST, MIAMI, FL, 33196, US |
| Mail Address: | 15190 SW 136TH ST, MIAMI, FL, 33196, US |
| ZIP code: | 33196 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811628951 | 2022-06-20 | 2023-06-14 | 15190 SW 136TH ST STE 26, MIAMI, FL, 331962618, US | 15190 SW 136TH ST STE 26-27, MIAMI, FL, 331962604, US | |||||||||||||||||||||
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| Phone | +1 786-404-1008 |
| Fax | 3057477166 |
Authorized person
| Name | TANIA H PEREZ GONZALEZ |
| Role | CEO |
| Phone | 7864041008 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 115780900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PEREZ GONZALEZ TANIA H | Agent | 14483 SW 172 LN, MIAMI, FL, 33177 |
| Name | Role | Address |
|---|---|---|
| PEREZ GONZALEZ TANIA H | President | 14483 SW 172 LN, MIAMI, FL, 33177 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000063482 | LIGHT OF HOPE MEDICAL CENTER | ACTIVE | 2023-05-22 | 2028-12-31 | No data | 15190 SW 136TH STREET, SUITE 26, MIAMI, FL, 33196 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-02-05 | 15190 SW 136TH ST, SUITE 26, 27, MIAMI, FL 33196 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-03-03 | 15190 SW 136TH ST, SUITE 26, 27, MIAMI, FL 33196 | No data |
| AMENDMENT | 2020-03-16 | No data | No data |
| AMENDMENT | 2020-01-29 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-01-14 | PEREZ GONZALEZ, TANIA HAYDEE | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J22000539876 | ACTIVE | 2021-009887-CA-01 | CIRCUIT COURT MIAMIDADE COUNTY | 2022-10-04 | 2027-12-02 | $170,408.24 | CIRAS, LLC, 3000 SMOOT ROAD, SUITE A, SMOOT, WEST VIRGINIA 24997 |
| J22000353237 | ACTIVE | 2021-005905-CA-01 | MIAMI-DADE CIRCUIT COURT | 2022-05-20 | 2027-07-21 | $115,113.02 | TD BANK, NATIONAL ASSOCIATION, ONE ROYAL ROAD, FLEMINGTON, NJ 08822 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-01-30 |
| AMENDED ANNUAL REPORT | 2022-03-03 |
| ANNUAL REPORT | 2022-01-12 |
| ANNUAL REPORT | 2021-03-11 |
| Amendment | 2020-03-16 |
| Amendment | 2020-01-29 |
| ANNUAL REPORT | 2020-01-14 |
| ANNUAL REPORT | 2019-03-29 |
| ANNUAL REPORT | 2018-03-11 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
