| Entity Name: | POINCIANA BEHAVIORAL HEALTH CLINIC INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 23 Jul 2020 (5 years ago) |
| Document Number: | P20000057032 |
| FEI/EIN Number | 85-3053012 |
| Address: | 51 N DOVERPLUM AVE., KISSIMMEE, FL, 34758, US |
| Mail Address: | 51 N DOVERPLUM AVE., KISSIMMEE, FL, 34758, US |
| ZIP code: | 34758 |
| County: | Osceola |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780286393 | 2020-11-10 | 2020-11-10 | PO BOX 584792, KISSIMMEE, FL, 34758, US | 2068 E OSCEOLA PKWY, KISSIMMEE, FL, 347438602, US | |||||||||||||||||||
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| Phone | +1 407-483-3939 |
| Fax | 4074494321 |
Authorized person
| Name | EULADIA MERCADO |
| Role | OWNER |
| Phone | 4075728862 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| RIVERA IVAN ADR | Agent | 51 N DOVERPLUM AVE., KISSIMMEE, FL, 34758 |
| Name | Role | Address |
|---|---|---|
| RIVERA IVAN ADR | President | 3885 BOWFIN TRAIL, KISSIMMEE, FL, 34746 |
| Name | Role | Address |
|---|---|---|
| MERCADO EULADIA | Vice President | 3885 BOWFIN TRAIL, KISSIMMEE, FL, 34746 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-19 | 51 N DOVERPLUM AVE., KISSIMMEE, FL 34758 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-19 | 51 N DOVERPLUM AVE., KISSIMMEE, FL 34758 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-19 | 51 N DOVERPLUM AVE., KISSIMMEE, FL 34758 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-19 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-04-30 |
| ANNUAL REPORT | 2021-04-27 |
| Domestic Profit | 2020-07-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
