| Entity Name: | AUTHENTIC INTEGRATIVE WELLNESS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 22 Jan 2019 (6 years ago) |
| Document Number: | P19000007421 |
| FEI/EIN Number | 83-3410966 |
| Address: | 1451 W CYPRESS CREEK RD., SUITE 300, FT LAUDERDALE, FL, 33309, US |
| Mail Address: | 1451 W Cypress Creek Road, Ft. Lauderdale, FL, 33309, US |
| ZIP code: | 33309 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922563634 | 2019-02-06 | 2019-03-20 | 2003 W CYPRESS CREEK RD STE 103, FORT LAUDERDALE, FL, 333091834, US | 2003 W CYPRESS CREEK RD STE 103, FORT LAUDERDALE, FL, 333091834, US | |||||||||||||||
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| Phone | +1 954-616-5246 |
| Fax | 7547016433 |
Authorized person
| Name | MRS. JESSICA VERA |
| Role | OWNER |
| Phone | 9546165246 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| VERA JESSICA LPH.D. | Agent | 9832 Grand Verde Way 203, Boca Raton, FL, 33428 |
| Name | Role | Address |
|---|---|---|
| VERA JESSICA LPH.D. | President | 1451 W CYPRESS CREEK RD, SUITE 300, FT LAUDERDALE, FL, 33309 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-04-04 | 1451 W CYPRESS CREEK RD., SUITE 300, FT LAUDERDALE, FL 33309 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-04 | 9832 Grand Verde Way 203, Boca Raton, FL 33428 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-03-14 | 1451 W CYPRESS CREEK RD., SUITE 300, FT LAUDERDALE, FL 33309 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-04 |
| ANNUAL REPORT | 2023-03-20 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-03-14 |
| ANNUAL REPORT | 2020-06-26 |
| Domestic Profit | 2019-01-22 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
