| Entity Name: | RANDOLPH BEHAVIORAL HEALTH SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 23 Sep 2020 (4 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 02 Oct 2023 (a year ago) |
| Document Number: | P20000076642 |
| FEI/EIN Number | 81-4988215 |
| Address: | 5700 Lake Worth RD, 106, Greenacres, FL 33463 |
| Mail Address: | Po box 4414, Boynton Beach, FL 33424 |
| ZIP code: | 33463 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932885738 | 2023-06-26 | 2024-05-24 | 5700 LAKE WORTH ROAD SUITE 108, GREENACRES, FL, 33463, US | 5700 LAKE WORTH ROAD SUITE 108, GREENACRES, FL, 33463, US | |||||||||||||||
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| Phone | +1 561-727-8641 |
| Fax | 5618994066 |
Authorized person
| Name | DAPHNE ROLLANDE CLAUDOMIR |
| Role | PRESIDENT |
| Phone | 5617278641 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CLAUDOMIR, DAPHNE R | Agent | 5700 Lake Worth Road, Suite 106, Greenacres, FL 33463 |
| Name | Role | Address |
|---|---|---|
| claudomir, Daphne | President | 5700 Lake Worth Road, Suite 106 Greenacres, FL 33463 |
| Name | Role | Address |
|---|---|---|
| claudomir, Daphne | Vice President | 5700 Lake Worth Road, Suite 106 Greenacres, FL 33463 |
| Name | Role | Address |
|---|---|---|
| claudomir, Daphne | Director | 5700 Lake Worth Road, Suite 106 Greenacres, FL 33463 |
| Name | Role | Address |
|---|---|---|
| claudomir, Daphne | Treasurer | 5700 Lake Worth Road, Suite 106 Greenacres, FL 33463 |
| Name | Role | Address |
|---|---|---|
| claudomir, Daphne | Secretary | 5700 Lake Worth Road, Suite 106 Greenacres, FL 33463 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000076569 | RANDOLPH DME | ACTIVE | 2023-06-26 | 2028-12-31 | No data | 5700 LAKE WORTH ROAD, SUITE 108, GREENACRES, FL, 33463 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2023-10-02 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-10-02 | 5700 Lake Worth Road, Suite 106, Greenacres, FL 33463 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-08-10 | 5700 Lake Worth RD, 106, Greenacres, FL 33463 | No data |
| CHANGE OF MAILING ADDRESS | 2021-09-28 | 5700 Lake Worth RD, 106, Greenacres, FL 33463 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-09-28 | CLAUDOMIR, DAPHNE R | No data |
| REINSTATEMENT | 2021-09-28 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-01 |
| REINSTATEMENT | 2023-10-02 |
| ANNUAL REPORT | 2022-08-10 |
| REINSTATEMENT | 2021-09-28 |
| Domestic Profit | 2020-09-23 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5896458502 | 2021-03-02 | 0455 | PPS | 3740 SW 47th Ave, West Park, FL, 33023-5557 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 14 Feb 2025
Sources: Florida Department of State
