| Entity Name: | J. CUSAAC, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 07 Jul 2015 (10 years ago) |
| Document Number: | P15000058342 |
| FEI/EIN Number | 47-4521938 |
| Address: | 6794 Park Lane E, LAKE WORTH, FL, 33449, US |
| Mail Address: | 6794 Park Lane E, Lake Worth, FL, 33449, US |
| ZIP code: | 33449 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750820254 | 2017-02-16 | 2017-02-16 | 11085 HARBOUR SPRINGS CIR, BOCA RATON, FL, 33428, US | 11085 HARBOUR SPRINGS CIR, BOCA RATON, FL, 334281244, US | |||||||||||||||||||||||||||
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| Phone | +1 561-445-9220 |
Authorized person
| Name | JACQUELINE A CUSAAC |
| Role | BCBA |
| Phone | 5614459220 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 018571500 |
| State | FL |
| Issuer | CIGNA |
| Number | 12759738 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CUSAAC Sekou | Agent | 8181 Springtree Rd, Boca Raton, FL, 33496 |
| Name | Role | Address |
|---|---|---|
| CUSAAC JACQUELINE A | President | 6794 Park Lane E, LAKE WORTH, FL, 33449 |
| Name | Role | Address |
|---|---|---|
| Cusaac Kamau D | Vice President | 6794 Park Lane E, LAKE WORTH, FL, 33449 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000116787 | OPTIMUM ABA THERAPY, INC. | ACTIVE | 2018-10-29 | 2028-12-31 | No data | 6794 PARK LN E, LAKE WORTH, FL, 33449 |
| G18000051195 | IT'S ABOUT BEHAVIOR | EXPIRED | 2018-04-24 | 2023-12-31 | No data | 11085 HARBOUR SPRINGS CIR, BOCA RATON, FL, 33428 |
| G18000050153 | IT'S ABOUT BEHAVIOR | EXPIRED | 2018-04-20 | 2023-12-31 | No data | BOCA RATON, BOCA RATON, FL, 33428 |
| G17000108013 | IT'S ABOUT THE BEHAVIOR | EXPIRED | 2017-09-29 | 2022-12-31 | No data | 11085 HARBOUR SPRINGS CIRCLE, BOCA RATON, FL, 33428 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-04-29 | CUSAAC, Sekou | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-02-27 | 6794 Park Lane E, LAKE WORTH, FL 33449 | No data |
| CHANGE OF MAILING ADDRESS | 2022-02-27 | 6794 Park Lane E, LAKE WORTH, FL 33449 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-02-27 | 8181 Springtree Rd, Boca Raton, FL 33496 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-29 |
| ANNUAL REPORT | 2022-02-27 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-05-28 |
| ANNUAL REPORT | 2019-05-01 |
| ANNUAL REPORT | 2018-04-20 |
| ANNUAL REPORT | 2017-04-29 |
| ANNUAL REPORT | 2016-08-31 |
| Domestic Profit | 2015-07-07 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
