| Entity Name: | PREMA BEHAVIORAL SERVICES INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 20 Jan 2021 (4 years ago) |
| Document Number: | P21000005018 |
| FEI/EIN Number | 86-1685633 |
| Address: | 1600 S Dixie HWY Suite 405, BOCA RATON, FL 33432 |
| Mail Address: | 1600 S Dixie HWY Suite 405, BOCA RATON, FL 33432 |
| ZIP code: | 33432 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902497365 | 2021-01-28 | 2024-05-06 | 240 W PALMETTO PARK RD STE 300C, BOCA RATON, FL, 334323761, US | 1600 S DIXIE HWY STE 405, BOCA RATON, FL, 334327454, US | |||||||||||||||||||||
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| Phone | +1 786-278-5903 |
| Phone | +1 786-508-3245 |
Authorized person
| Name | YAILET DELGADO |
| Role | OWNER |
| Phone | 7862785903 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 832158 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DELGADO, YAILET | Agent | 1600 S Dixie Hwy Suite 405, BOCA RATON, FL 33432 |
| Name | Role | Address |
|---|---|---|
| DELGADO, YAILET | President | 1600 S DIXIE HWY SUITE 405, BOCA RATON, FL 33432 |
| JUAN MIGUEL CAMPELLO | President | 1600 S DIXIE HWY SUITE 405, BOCA RATON, FL 33432 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-01-24 | 1600 S Dixie HWY Suite 405, BOCA RATON, FL 33432 | No data |
| CHANGE OF MAILING ADDRESS | 2024-01-24 | 1600 S Dixie HWY Suite 405, BOCA RATON, FL 33432 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-01-24 | 1600 S Dixie Hwy Suite 405, BOCA RATON, FL 33432 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-24 |
| ANNUAL REPORT | 2023-04-10 |
| ANNUAL REPORT | 2022-04-29 |
| Domestic Profit | 2021-01-20 |
Date of last update: 14 Feb 2025
Sources: Florida Department of State
