| Entity Name: | PREFERRED BEHAVIORAL HEALTH PROVIDER GROUP, PLLC |
| Jurisdiction: | Illinois |
| Entity Type: | Limited Liability Company |
| Status: | NGS |
| Date Formed: | 03 Sep 2020 |
| Company Number: | LLC_09028463 |
| File Number: | 09028463 |
| Type of Management: | Manager Managed |
| Date Status Change: | 01 Sep 2024 |
| Address | 141 MARKET PLACE DR. STE 100, FAIRVIEW HTS., 62208, IL |
| Place of Formation: | ILLINOIS |
| Name and Address | Role | Appointment Date |
|---|---|---|
| RYAN W. MORRIS, 141 MARKET PLACE DR. STE 100, FAIRVIEW HTS., 62208 | Agent | 2020-09-03 |
| Name and Address | Role | Appointment Date |
|---|---|---|
| WATKINS, BEVERLY B., 141 MARKET PLACE DR. STE 100, FAIRVIEW HEIGHTS, IL, 62208 | Manager | 2023-08-31 |
| HITPAS, KATHLEEN A., 141 MARKET PLACE DR. STE 100, FAIRVIEW HEIGHTS, IL, 62208 | Manager | 2023-08-31 |
| JACKSON, MARIAN A., 141 MARKET PLACE DR. STE 100, FAIRVIEW HEIGHTS, IL, 62208 | Manager | 2023-08-31 |
| RAY, SHONTEL M., 141 MARKET PLACE DR. STE 100, FAIRVIEW HEIGHTS, IL, 62208 | Manager | 2023-08-31 |
| BOYD, NICOLE M., 141 MARKET PLACE DR. STE 100, FAIRVIEW HEIGHTS, IL, 62208 | Manager | 2023-08-31 |
| EBELE N ILOABACHIE, 141 MARKET PLACE DR. STE 100, FAIRVIEW HEIGHTS, IL, 62208 | Manager | 2023-08-31 |
| License Type | License Number | Status | License Code | License Description | Business Activity | Date Issued | Effective Date | Expiration Date |
|---|---|---|---|---|---|---|---|---|
| LIMITED LIABILITY CO | 248003432 | No data | No data | PROFESSIONAL LIMITED LIABILITY COMPANY | No data | 2022-02-15 | 2022-02-15 | 2025-01-01 |
Date of last update: 23 Dec 2024
