| Entity Name: | LIVEWELL BEHAVIORAL HEALTH CORP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 07 Jan 2020 (5 years ago) |
| Document Number: | P20000004168 |
| FEI/EIN Number | 844416539 |
| Address: | 200 S HARBOR CITY BLVD, Suite 401, MELBOURNE, FL, 32901, US |
| Mail Address: | 200 S HARBOR CITY BLVD, Suite 401, MELBOURNE, FL, 32901, US |
| ZIP code: | 32901 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770185308 | 2020-11-09 | 2020-11-09 | 200 S HARBOR CITY BLVD, MELBOURNE, FL, 329011384, US | 200 S HARBOR CITY BLVD, MELBOURNE, FL, 329011384, US | |||||||||||||||||||||||
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| Phone | +1 321-259-1662 |
| Fax | 3212591223 |
Authorized person
| Name | MRS. CATHY CROMARTIE |
| Role | DIRECTOR OF OPERATIONS |
| Phone | 3214467150 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
| Taxonomy Code | 103T00000X - Psychologist |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| RONSISVALLE RICHARD M | Agent | 160 Hacienda Drive, Merritt Island, FL, 32952 |
| Name | Role | Address |
|---|---|---|
| RONSISVALLE RICHARD M | President | 200 S HARBOR CITY BLVD, MELBOURNE, FL, 32901 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000129077 | FLORIDA COUNSELING CENTERS | ACTIVE | 2020-10-05 | 2025-12-31 | No data | 100 S HARBOR CITY BLVD, MELBOURNE, FL, 32901 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-02-11 | 200 S HARBOR CITY BLVD, Suite 401, MELBOURNE, FL 32901 | No data |
| CHANGE OF MAILING ADDRESS | 2021-02-11 | 200 S HARBOR CITY BLVD, Suite 401, MELBOURNE, FL 32901 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-02-11 | 160 Hacienda Drive, Merritt Island, FL 32952 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-04-18 |
| ANNUAL REPORT | 2022-02-03 |
| ANNUAL REPORT | 2021-02-11 |
| Domestic Profit | 2020-01-07 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
