HEALING EDUCATIONAL ALTERNATIVES FOR DESERVING STUDENTS
Mental Health at Laura St, Jacksonville, FL

License number
Florida 05
Category
Mental Health
Type
Mental Health
Owner
Name: EDWARD A WALLER M.ED
Title: COO
Phone: (813) 754-5555
Address
Address 2
50 N Laura St SUITE 2500, Jacksonville, FL 32202
1001 E Baker St SUITE 202, Plant City, FL 33563
National Provider ID: 1437550266
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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HEALING EDUCATIONAL ALTERNATIVES FOR DESERVING STUDENTS, LLC

Plant City, FL  -  Tampa, FL

Status:
Inactive
Industry:
Nonclassifiable Establishments
Inactive reason:
LC AMENDMENT
Registration:
Feb 23, 2012
Inactive since:
Sep 8, 2014
Addresses:
1001 E Baker St 100, Plant City, FL 33563 (Physical)
1001 E Baker St 202, Plant City, FL 33563 (Mailing)
701 S Howard Ave, Tampa, FL 33606
1001 E Baker St, Plant City, FL 33563
State ID:
L12000025921
Business type:
Florida Limited Liability Company
S:
Edward Ajr. Waller (Managing Member), PO Box 455, Trilby, FL 33593 (Physical),Judith E Waller, 38148 Mickler Rd, Dade City, FL 33523 (Physical),Katherine S. Waller inactive
Agent:
Jeffrey Wood,1 Financial Plz SUITE 2602, Fort Lauderdale, FL 33394 (Physical)
EIN:
45-4924934

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