| Entity Name: | FAMILY SERVICE AGENCY INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Inactive |
| Date Filed: | 07 Apr 1961 (64 years ago) |
| Document Number: | 702244 |
| FEI/EIN Number | 590824455 |
| Address: | 3347 N UNIVERSITY DR, DAVIE, FL, 33024 |
| Mail Address: | 3347 N. UNIVERSITY DRIVE, DAVIE, FL, 33024 |
| ZIP code: | 33024 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295860146 | 2007-02-22 | 2020-08-22 | 3347 N UNIVERSITY DR, HOLLYWOOD, FL, 330242299, US | 3347 N UNIVERSITY DR, HOLLYWOOD, FL, 330242299, US | |||||||||||||||
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| Phone | +1 954-587-7880 |
| Fax | 9545873229 |
Authorized person
| Name | DR. BRUCE C WALLIN |
| Role | PRESIDENT AND CEO |
| Phone | 9545877880 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| WALLIN BRUCE J | Agent | 3347 N. UNIVERSITY DRI VE, DAVIE -FL, FL, 33024 |
| Name | Role | Address |
|---|---|---|
| MYRICK BARBARA J | Chairman | 600 S.E. 3RD AVENUE, 7TH FLOOR, FORT LAUDERDALE, FL, 33301 |
| Name | Role | Address |
|---|---|---|
| MYRICK BARBARA J | Director | 600 S.E. 3RD AVENUE, 7TH FLOOR, FORT LAUDERDALE, FL, 33301 |
| HANCOCK HAROLD | Director | 3003 TERRAMAR ST 801, FORT LAUDERDALE, FL, 33304 |
| WALLIN, BRUCE C | Director | 1431 NE 17TH AVE, FT LAUDERDALE, FL |
| DEMORE JOEANN | Director | 2863 EXECUTIVE PARK DRIVE, SUITE 105, WESTON, FL, 33331 |
| Name | Role | Address |
|---|---|---|
| HANCOCK HAROLD | Treasurer | 3003 TERRAMAR ST 801, FORT LAUDERDALE, FL, 33304 |
| Name | Role | Address |
|---|---|---|
| WALLIN, BRUCE C | President | 1431 NE 17TH AVE, FT LAUDERDALE, FL |
| Name | Role | Address |
|---|---|---|
| DEMORE JOEANN | Secretary | 2863 EXECUTIVE PARK DRIVE, SUITE 105, WESTON, FL, 33331 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| EVENT CONVERTED TO NOTES | 1961-04-07 | No data | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
