| Entity Name: | ADVANCED BEHAVIORAL CLINICIANS INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 27 Nov 2018 (6 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | P18000096813 |
| Address: | 2740 COCONUT BAY LANE STE 3G, SARASOTA, FL 34237 |
| Mail Address: | 2740 COCONUT BAY LANE STE 3G, SARASOTA, FL 34237 |
| ZIP code: | 34237 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639793326 | 2020-05-29 | 2022-08-26 | 20 MEADOWBROOK LN, PALMER, MA, 010691134, US | 2650 BAHIA VISTA ST STE 209, SARASOTA, FL, 342392625, US | |||||||||||||||||||||||||
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| Phone | +1 941-870-3600 |
| Fax | 7279988401 |
Authorized person
| Name | ADAIR LYNNE DEICKE |
| Role | OWNER/CEO |
| Phone | 7272399938 |
Taxonomy
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 008642300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MANN, STEVAN | Agent | 37375 US HWY 19 STE 21, CLEARWATER, FL 34232 |
| Name | Role | Address |
|---|---|---|
| MANN, MICHAEL | Director | 2740 COCONUT BAY LANE STE 3G, SARASOTA, FL 34237 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| Name | Date |
|---|---|
| Domestic Profit | 2018-11-27 |
Date of last update: 16 Feb 2025
Sources: Florida Department of State
