| Entity Name: | ELDER LIFE MENTAL HEALTH INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 16 Feb 2021 (4 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 08 Jul 2022 (3 years ago) |
| Document Number: | P21000014372 |
| FEI/EIN Number | 86-2183721 |
| Address: | 18140-18142 SW 97TH AVE, PALMETTO BAY, FL 33157 |
| Mail Address: | 18140-18142 SW 97TH AVE, PALMETTO BAY, FL 33157 |
| ZIP code: | 33157 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891579538 | 2023-08-23 | 2023-08-23 | 18142 SW 97TH AVE, PALMETTO BAY, FL, 331575501, US | 18142 SW 97TH AVE, PALMETTO BAY, FL, 331575501, US | |||||||||||||||||
|
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| Phone | +1 786-830-4316 |
Authorized person
| Name | BETSY GUEVARA RUIZ |
| Role | PRESIDENT |
| Phone | 7868304316 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| GUEVARA RUIZ, BETSY | Agent | 18140-18142 SW 97TH AVE, PALMETTO BAY, FL 33157 |
| Name | Role | Address |
|---|---|---|
| GUEVARA RUIZ, BETSY | President | 18140-18142 SW 97TH AVE, PALMETTO BAY, FL 33157 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000095114 | GUEVARA MEDICAL SERVICES | ACTIVE | 2023-08-15 | 2028-12-31 | No data | 18142 SW 97TH AVE, PALMETTO BAY, FL, 33157 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2022-07-08 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-07-08 | 18140-18142 SW 97TH AVE, PALMETTO BAY, FL 33157 | No data |
| CHANGE OF MAILING ADDRESS | 2022-07-08 | 18140-18142 SW 97TH AVE, PALMETTO BAY, FL 33157 | No data |
| AMENDMENT | 2021-11-01 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2021-11-01 | GUEVARA RUIZ, BETSY | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-11-01 | 18140-18142 SW 97TH AVE, PALMETTO BAY, FL 33157 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-22 |
| ANNUAL REPORT | 2023-02-07 |
| Amendment | 2022-07-08 |
| ANNUAL REPORT | 2022-04-29 |
| Amendment | 2021-11-01 |
| Domestic Profit | 2021-02-16 |
Date of last update: 14 Feb 2025
Sources: Florida Department of State
