| Entity Name: | AXIS BEHAVIORAL HEALTH, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 21 Jun 1993 (32 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 03 Oct 2014 (10 years ago) |
| Document Number: | P93000043623 |
| FEI/EIN Number | 65-0417720 |
| Mail Address: | 6840 SW 40th St, suite 205-206, MIAMI, FL 33155 |
| Address: | 6840 BIRD ROAD, SUITE # 205, MIAMI, FL 33155 |
| ZIP code: | 33155 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861614992 | 2007-05-02 | 2020-08-22 | 6840 BIRD ROAD, SUITE 205, MIAMI, FL, 33155, US | 6840 BIRD ROAD, MIAMI, FL, 33155, US | |||||||||||||||||||||||||||||||
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| Phone | +1 305-668-0634 |
| Fax | 3055511210 |
Authorized person
| Name | LORIANA M NOVOA |
| Role | PRESIDENT |
| Phone | 3056680634 |
Taxonomy
| Taxonomy Code | 311Z00000X - Custodial Care Facility |
| License Number | 9050 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PROVIDER NUMBER |
| Number | 235271 |
| State | FL |
| Issuer | PROVIDER NUMBER |
| Number | 60-70164 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| COMPANIONI, JOSE MANUEL ESQ. | Agent | 5905 S.W. 94TH PLACE, MIAMI, FL 33173 |
| Name | Role | Address |
|---|---|---|
| NOVOA, LORIANA MED.O | President | 6840, BIRD RD STE 205 MIAMI, FL 33155 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000125739 | CASA AXIS | EXPIRED | 2019-11-25 | 2024-12-31 | No data | P.O. BOX 940156, MIAMI, FL, 33194 |
| G18000081730 | CENTRO AXIS | ACTIVE | 2018-07-31 | 2028-12-31 | No data | 6840 SW 40ST, 205-26, MIAMI, FL, 33155 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2022-01-21 | 6840 BIRD ROAD, SUITE # 205, MIAMI, FL 33155 | No data |
| REINSTATEMENT | 2014-10-03 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2007-05-01 | 6840 BIRD ROAD, SUITE # 205, MIAMI, FL 33155 | No data |
| REGISTERED AGENT NAME CHANGED | 2001-10-08 | COMPANIONI, JOSE MANUEL ESQ. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2001-10-08 | 5905 S.W. 94TH PLACE, MIAMI, FL 33173 | No data |
| NAME CHANGE AMENDMENT | 1997-03-11 | AXIS BEHAVIORAL HEALTH, INC. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-01-19 |
| ANNUAL REPORT | 2022-01-21 |
| ANNUAL REPORT | 2021-01-27 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-04-09 |
| ANNUAL REPORT | 2018-02-07 |
| ANNUAL REPORT | 2017-01-06 |
| ANNUAL REPORT | 2016-03-07 |
| ANNUAL REPORT | 2015-06-10 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 6024527707 | 2020-05-01 | 0455 | PPP | 6840 BIRD RD STE 205-206, MIAMI, FL, 33155-3762 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2543658308 | 2021-01-21 | 0455 | PPS | 6840 Bird Rd, Miami, FL, 33155-3762 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Feb 2025
Sources: Florida Department of State
