| Entity Name: | CHILDREN'S THERAPY ASSOCIATES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 16 Sep 1997 (27 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 19 May 1999 (26 years ago) |
| Document Number: | P97000080724 |
| FEI/EIN Number | 593473792 |
| Address: | 3911 GOLF PARK LOOP, UNIT 105, BRADENTON, FL, 34203 |
| Mail Address: | 3911 GOLF PARK LOOP, UNIT 105, BRADENTON, FL, 34203 |
| ZIP code: | 34203 |
| County: | Manatee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245286145 | 2006-05-25 | 2020-08-22 | 3911 GOLF PARK LOOP, SUITE #105, BRADENTON, FL, 342033453, US | 3911 GOLF PARK LOOP, SUITE #105, BRADENTON, FL, 342033453, US | |||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 941-756-1003 |
| Fax | 9417566003 |
Authorized person
| Name | MR. DONALD A. BOULANGER |
| Role | CO-OWNER |
| Phone | 9417561003 |
Taxonomy
| Taxonomy Code | 224Z00000X - Occupational Therapy Assistant |
| Is Primary | No |
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | No |
| Taxonomy Code | 225200000X - Physical Therapy Assistant |
| Is Primary | No |
| Taxonomy Code | 225X00000X - Occupational Therapist |
| Is Primary | No |
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | Y902F |
| State | FL |
| Issuer | WELLCARE |
| Number | 173360 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BOULANGER DONALD | Agent | 3911 GOLF PARK LOOP, BRADENTON, FL, 34203 |
| Name | Role | Address |
|---|---|---|
| BOULANGER DONALD | President | 3911 GOLF PARK LOOP, BRADENTON, FL, 34203 |
| Name | Role | Address |
|---|---|---|
| TAYLOR SUE | Vice President | 3911 GOLF PARK LOOP, BRADENTON, FL, 34203 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2006-01-12 | 3911 GOLF PARK LOOP, UNIT 105, BRADENTON, FL 34203 | No data |
| CHANGE OF MAILING ADDRESS | 2006-01-12 | 3911 GOLF PARK LOOP, UNIT 105, BRADENTON, FL 34203 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2006-01-12 | 3911 GOLF PARK LOOP, UNIT 105, BRADENTON, FL 34203 | No data |
| NAME CHANGE AMENDMENT | 1999-05-19 | CHILDREN'S THERAPY ASSOCIATES, INC. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-29 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-03-25 |
| ANNUAL REPORT | 2021-02-19 |
| ANNUAL REPORT | 2020-03-13 |
| ANNUAL REPORT | 2019-05-03 |
| ANNUAL REPORT | 2018-03-19 |
| ANNUAL REPORT | 2017-04-06 |
| ANNUAL REPORT | 2016-04-29 |
| ANNUAL REPORT | 2015-02-24 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
