| Entity Name: | SHANLIS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 15 Jul 1996 (29 years ago) |
| Document Number: | P96000058867 |
| FEI/EIN Number | 650677624 |
| Address: | 744 colorado avenue, STUART, FL, 34994, US |
| Mail Address: | 2231 SW Parkridge Pl, PALM CITY, FL, 34990, US |
| ZIP code: | 34994 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700214459 | 2013-10-16 | 2016-10-10 | 744 COLROADO AVE, STUART, FL, 349942918, US | 744 COLROADO AVE, STUART, FL, 349942918, US | |||||||||||||||||||
|
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| Phone | +1 772-223-9988 |
| Fax | 7722239593 |
Authorized person
| Name | DR. THEODORE G WILLIAMS |
| Role | CLINICAL DIRECTOR |
| Phone | 7722239988 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY5917 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| WILLIAMS THEODORE G | Agent | 2231 SW Parkridge Pl, PALM CITY, FL, 34990 |
| Name | Role | Address |
|---|---|---|
| Williams Theodore G | President | 2231 SW Parkridge Pl, PALM CITY, FL, 34990 |
| Name | Role | Address |
|---|---|---|
| EDNEY STEVEN | Vice President | 6620 SW GAINES AVE, STUART, FL, 34937 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT AND NAME CHANGE | 2016-07-11 | SHANLIS, INC. | No data |
| NAME CHANGE AMENDMENT | 2006-02-06 | SHANLIS COUNSELING AND ASSESSMENT, INC. | No data |
| NAME CHANGE AMENDMENT | 1999-09-22 | SUNCOAST COUNSELING AND ASSESSMENT, INC. | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
