| Entity Name: | AYL BEHAVIORAL SERVICES INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 29 Jan 2024 (a year ago) |
| Document Number: | P24000007804 |
| Address: | 45 Barkley Circle, Fort Myers, FL, 33907, UN |
| Mail Address: | 45 Barkley Circle, Fort Myers, FL, 33907, UN |
| ZIP code: | 33907 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649034638 | 2024-02-09 | 2024-02-09 | 2224 OASIS PALM CIR APT 200, CAPE CORAL, FL, 339913469, US | 2224 OASIS PALM CIR APT 200, CAPE CORAL, FL, 339913469, US | |||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 786-325-4721 |
Authorized person
| Name | YISET GARCIA |
| Role | THERAPIST/ OWNER |
| Phone | 7863254721 |
Taxonomy
| Taxonomy Code | 103T00000X - Psychologist |
| Is Primary | No |
| Taxonomy Code | 103TR0400X - Rehabilitation Psychologist |
| Is Primary | No |
| Taxonomy Code | 106S00000X - Behavior Technician |
| Is Primary | No |
| Taxonomy Code | 163WH0200X - Home Health Registered Nurse |
| Is Primary | No |
| Taxonomy Code | 163WP0000X - Pain Management Registered Nurse |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
| Taxonomy Code | 363LP2300X - Primary Care Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| GARCIA YISET | Agent | 2224 OASIS PALM CIR, CAPE CORAL, FL, 33991 |
| Name | Role | Address |
|---|---|---|
| GARCIA YISET | President | 2224 OASIS PALM CIR APT 200, CAPE CORAL, FL, 33991 |
| Name | Role | Address |
|---|---|---|
| NODAL ANIBAL | Vice President | 2224 OASIS PALM CIR APT 200, CAPE CORAL, FL, 33991 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-09-19 | 45 Barkley Circle, Fort Myers, FL 33907 UN | No data |
| CHANGE OF MAILING ADDRESS | 2024-09-19 | 45 Barkley Circle, Fort Myers, FL 33907 UN | No data |
| Name | Date |
|---|---|
| Domestic Profit | 2024-01-29 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
