| Entity Name: | FSBA, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 03 Apr 2015 (10 years ago) |
| Document Number: | P15000030886 |
| FEI/EIN Number | 47-3639770 |
| Address: | 19802 OLD BELLAMY ROAD, ALACHUA, FL, 32615, US |
| Mail Address: | 19802 OLD BELLAMY ROAD, ALACHUA, FL, 32615, US |
| ZIP code: | 32615 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427508100 | 2016-10-06 | 2016-10-06 | 19802 OLD BELLAMY RD, ALACHUA, FL, 326153867, US | 19802 OLD BELLAMY RD, ALACHUA, FL, 326153867, US | |||||||||||||||||
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| Phone | +1 352-278-1920 |
Authorized person
| Name | SUSAN DEBORAH CLIETT |
| Role | CEO |
| Phone | 3522781920 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | MH2814 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CLIETT SUSAN D | Agent | 19802 BELLAMY ROAD, ALACHUA, FL, 32615 |
| Name | Role | Address |
|---|---|---|
| CLIETT SUSAN D | President | 19802 OLD BELLAMY ROAD, ALACHUA, FL, 32615 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-26 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-04-27 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-06-18 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-04-26 |
| ANNUAL REPORT | 2017-04-26 |
| ANNUAL REPORT | 2016-04-29 |
| Domestic Profit | 2015-04-03 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
