| Entity Name: | BALANCED MENTAL HEALTH INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 21 Jul 2022 (3 years ago) |
| Document Number: | P22000058515 |
| FEI/EIN Number | APPLIED FOR |
| Address: | 15280 DURANGO CIR, BROOKSVILLE, FL, 34604, US |
| Mail Address: | 15280 DURANGO CIR, BROOKSVILLE, FL, 34604, US |
| ZIP code: | 34604 |
| County: | Hernando |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013624402 | 2022-11-03 | 2022-11-07 | 15280 DURANGO CIR, BROOKSVILLE, FL, 346045003, US | 15280 DURANGO CIR, BROOKSVILLE, FL, 346045003, US | |||||||||||||||||||||||||
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| Phone | +1 727-382-3538 |
| Fax | 7274167061 |
Authorized person
| Name | JASMIN PERRY |
| Role | OWNER/PROVIDER |
| Phone | 7273823538 |
Taxonomy
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | ANCC PMHNP-BC CERTIFICATION |
| Number | 2018080999 |
| Issuer | ADVANCED PRACTICE REGISTERED NURSE |
| Number | 9311097 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PERRY JASMIN | Agent | 15280 DURANDO CIR, BROOKSVILLE, FL, 34604 |
| Name | Role | Address |
|---|---|---|
| PERRY JASMIN | President | 15280 DURANGO CIR, BROOKSVILLE, FL, 34604 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-15 |
| ANNUAL REPORT | 2023-04-29 |
| Domestic Profit | 2022-07-21 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
