| Entity Name: | LANSHEL INCORPORATED |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 Aug 2017 (7 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 03 Jun 2019 (6 years ago) |
| Document Number: | P17000071806 |
| FEI/EIN Number | 82-3132391 |
| Address: | 4850 W. Oakland Park Blvd, 145, Lauderdale Lakes, FL, 33313, US |
| Mail Address: | 4850 W. Oakland Park Blvd, Lauderdale Lakes, FL, 33313, US |
| ZIP code: | 33313 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1396253027 | 2018-01-16 | 2023-12-18 | 4850 W OAKLAND PARK BLVD STE 145, LAUDERDALE LAKES, FL, 333137277, US | 4850 W OAKLAND PARK BLVD STE 145, LAUDERDALE LAKES, FL, 333137277, US | |||||||||||||||||||||||||||||||||||
|
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| Phone | +1 954-933-3407 |
| Fax | 7542054528 |
Authorized person
| Name | DR. SANDRA K LANGE |
| Role | CEO/ PRESIDENT |
| Phone | 9544015675 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 107203000 |
| State | FL |
| Issuer | MEDICAID |
| Number | 1336597590 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LANGE SANDRA KDR | Agent | 4850 W. Oakland Park Blvd, Lauderdale Lakes, FL, 33313 |
| Name | Role | Address |
|---|---|---|
| BROWN-FAISON KERRY-ANN LCSW | President | 4850 W. Oakland Park Blvd, Lauderdale Lakes, FL, 33313 |
| Name | Role | Address |
|---|---|---|
| LANGE SANDRA PSYD | Chief Executive Officer | 4850 W. Oakland Park Blvd, Lauderdale Lakes, FL, 33313 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000009530 | AMETHYST AGENCY OF BROWARD | ACTIVE | 2021-01-20 | 2026-12-31 | No data | 4850 W OAKLAND PK BLVD #145, LAUDERDALE LAKE, FL, 33313 |
| G21000002874 | AMETHYST CASE MANAGEMENT AGENCY | ACTIVE | 2021-01-06 | 2026-12-31 | No data | 555 S ANDREWS AVE, 105, POMPANO BEACH, FL, 33069 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-01-26 | 4850 W. Oakland Park Blvd, 145, 145, Lauderdale Lakes, FL 33313 | No data |
| CHANGE OF MAILING ADDRESS | 2023-01-26 | 4850 W. Oakland Park Blvd, 145, 145, Lauderdale Lakes, FL 33313 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-01-26 | 4850 W. Oakland Park Blvd, 145, Lauderdale Lakes, FL 33313 | No data |
| AMENDMENT | 2019-06-03 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-15 |
| ANNUAL REPORT | 2024-01-29 |
| ANNUAL REPORT | 2023-01-26 |
| ANNUAL REPORT | 2022-03-23 |
| ANNUAL REPORT | 2021-01-26 |
| ANNUAL REPORT | 2020-04-29 |
| Amendment | 2019-06-03 |
| ANNUAL REPORT | 2019-01-07 |
| ANNUAL REPORT | 2018-04-27 |
| Domestic Profit | 2017-08-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
