| Entity Name: | KLEIN BEHAVIOR ANALYSIS INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 09 Dec 2015 (9 years ago) |
| Date of dissolution: | 25 Sep 2020 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 years ago) |
| Document Number: | P15000098697 |
| FEI/EIN Number | 81-0772572 |
| Address: | 809-811 PATRICK STREET, KISSIMMEE, FL 34741 |
| Mail Address: | 809-811 PATRICK STREET, KISSIMMEE, FL 34741 |
| ZIP code: | 34741 |
| County: | Osceola |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497120992 | 2015-12-09 | 2022-07-21 | 809 PATRICK ST, KISSIMMEE, FL, 347415639, US | 809 PATRICK ST, KISSIMMEE, FL, 347415639, US | |||||||||||||||||||||
|
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| Phone | +1 321-401-7026 |
| Fax | 3212064560 |
Authorized person
| Name | WILLIAM KLEIN |
| Role | EXECUTIVE & CLINICAL DIRECTOR |
| Phone | 3214017026 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 020074500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PEREA, IVETT | Agent | 4301 NW 168 TERRACE, MIAMI, FL 33055 |
| Name | Role | Address |
|---|---|---|
| KLEIN, WILLIAM | PRESIDENT | 335 N MAGNOLIA AVE,, APT 1402 ORLANDO, FL 32801 |
| Name | Role | Address |
|---|---|---|
| KLEIN, WILLIAM | SECRETARY | 335 N MAGNOLIA AVE,, APT 1402 ORLANDO, FL 32801 |
| Name | Role | Address |
|---|---|---|
| KLEIN, WILLIAM | TREASURER | 335 N MAGNOLIA AVE,, APT 1402 ORLANDO, FL 32801 |
| Name | Role | Address |
|---|---|---|
| PEREA, IVETT | Vice President | 4301 NW 168 TERRACE, MIAMI, FL 33055 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-05-02 | 809-811 PATRICK STREET, KISSIMMEE, FL 34741 | No data |
| CHANGE OF MAILING ADDRESS | 2019-05-02 | 809-811 PATRICK STREET, KISSIMMEE, FL 34741 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-03-30 |
| ANNUAL REPORT | 2018-01-15 |
| AMENDED ANNUAL REPORT | 2017-05-03 |
| ANNUAL REPORT | 2017-04-13 |
| Domestic Profit | 2015-12-09 |
Date of last update: 20 Jan 2025
Sources: Florida Department of State
