| Entity Name: | GOOD SHEPHERD PSYCHIATRIC & MEDICAL CENTER INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 04 Jan 2023 (2 years ago) |
| Document Number: | P23000001502 |
| FEI/EIN Number | 92-1653911 |
| Address: | 9050 PINES BLVD, 425-427 & 428, PEMBROKE PINES, FL 33024 |
| Mail Address: | 9050 PINES BLVD, 425-427 & 428, PEMBROKE PINES, FL 33024 |
| ZIP code: | 33024 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487342424 | 2023-04-27 | 2024-10-15 | 9050 PINES BLVD # 428, PEMBROKE PNES, FL, 330246455, US | 9050 PINES BLVD STE 425-428, PEMBROKE PNES, FL, 330246455, US | |||||||||||||||||||||||
|
|||||||||||||||||||||||||||
| Phone | +1 954-271-5676 |
| Fax | 9542715779 |
Authorized person
| Name | CHANTALE D PIERRE |
| Role | TREASURER/MANAGER |
| Phone | 3524594164 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | No |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PIERRE, URMENE | Agent | 9050 PINES BLVD, 425-427 & 428, PEMBROKE PINES, FL 33024 |
| Name | Role | Address |
|---|---|---|
| PIERRE, ROCHENEL | President | 9050 PINES BLVD 425-427 & 428, PEMBROKE PINES, FL 33024 |
| Name | Role | Address |
|---|---|---|
| PIERE, URMENE | Vice President | 9050 PINES BLVD 425-427 & 428, PEMBROKE PINES, FL 33024 |
| Name | Role | Address |
|---|---|---|
| PIERRE, CHANTALE | Treasurer | 9050 PINES BLVD 425-427 & 428, PEMBROKE PINES, FL 33024 |
| Name | Role | Address |
|---|---|---|
| PIERRE, CHILINE | Director | 9050 PINES BLVD 425-427 & 428, PEMBROKE PINES, FL 33024 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-05 |
| Domestic Profit | 2023-01-04 |
Date of last update: 11 Jan 2025
Sources: Florida Department of State
