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CHARLOTTE BEHAVIORAL HEALTH CARE, INC. - Florida Company Profile

Company Details

Entity Name: CHARLOTTE BEHAVIORAL HEALTH CARE, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 15 Jul 1968 (57 years ago)
Last Event: NAME CHANGE AMENDMENT
Event Date Filed: 13 Sep 2006 (19 years ago)
Document Number: 714950
FEI/EIN Number 591234922

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 1700 EDUCATION AVENUE, PUNTA GORDA, FL, 33950
Mail Address: 1700 EDUCATION AVENUE, PUNTA GORDA, FL, 33950
ZIP code: 33950
County: Charlotte
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1760460653 2006-01-03 2022-05-24 1700 EDUCATION AVE, PUNTA GORDA, FL, 339506222, US 1700 EDUCATION AVE, PUNTA GORDA, FL, 339506222, US

Contacts

Phone +1 941-639-8300
Fax 9416396831

Authorized person

Name MR. RALPH JAY GLYNN
Role CEO
Phone 9416398300

Taxonomy

Taxonomy Code 101YA0400X - Addiction (Substance Use Disorder) Counselor
License Number 0808AD492200
State FL
Is Primary No
Taxonomy Code 101YM0800X - Mental Health Counselor
License Number 0808AD492200
State FL
Is Primary Yes
Taxonomy Code 1041C0700X - Clinical Social Worker
License Number 0808AD492200
State FL
Is Primary No
Taxonomy Code 251S00000X - Community/Behavioral Health Agency
License Number 1477
State FL
Is Primary No
Taxonomy Code 324500000X - Substance Abuse Rehabilitation Facility
License Number 2008AD4922-00-P
State FL
Is Primary No

Other Provider Identifiers

Issuer MEDICAID
Number 141305800
State FL
Issuer BLUE CROSS
Number 97564
State FL
Issuer MEDICAID
Number 060480100
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CHARLOTTE BEHAVIORAL HEALTH CARE, INC. RETIREMENT PLAN 2017 591234922 2018-10-16 CHARLOTTE BEHAVIORAL HEALTH CARE, INC. 317
Three-digit plan number (PN) 001
Effective date of plan 1989-01-01
Business code 621420
Sponsor’s telephone number 9416398300
Plan sponsor’s mailing address 1700 EDUCATION AVENUE, PUNTA GORDA, FL, 33950
Plan sponsor’s address 1700 EDUCATION AVENUE, PUNTA GORDA, FL, 33950

Number of participants as of the end of the plan year

Active participants 218
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 143
Number of participants with account balances as of the end of the plan year 328
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 12

Signature of

Role Plan administrator
Date 2018-10-15
Name of individual signing JENNIFER BORTOLINI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-15
Name of individual signing VICTORIA SCANLON
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
STEWART LARRY Vice President 1135 SOCORRO DR, PUNTA GORDA, FL, 33950
GRANT MICHAEL Director P.O. BOX 494317, PORT CHARLOTTE, FL, 33949
ROGERS DEREK A Chief Financial Officer 1700 EDUCATION AVENUE, PUNTA GORDA, FL, 33950
James Bill Treasurer 1700 EDUCATION AVENUE, PUNTA GORDA, FL, 33950
Worthley Donna Director 1700 EDUCATION AVENUE, PUNTA GORDA, FL, 33950
Andrews Paul President 1700 EDUCATION AVENUE, PUNTA GORDA, FL, 33950
Scanlon Victoria C Agent 1700 EDUCATION AVE, PUNTA GORDA, FL, 33950

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G15000021559 S.H.A.R.E SPOT ACTIVE 2015-02-27 2025-12-31 - 1700 EDUCATION AVE, PUNTA GORDA, FL, 33950
G14000113552 DESOTO PSYCHIATRIC SERVICES ACTIVE 2014-11-11 2029-12-31 - 513 EAST HICKORY STREET, ARCADIA, FL, 34266
G12000110063 NORTHSIDE PSYCHIATRIC SERVICES ACTIVE 2012-11-14 2027-12-31 - 21500 GIBRALTER DR., PORT CHARLOTTE, FL, 33952

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2017-01-11 Scanlon, Victoria CEO -
NAME CHANGE AMENDMENT 2006-09-13 CHARLOTTE BEHAVIORAL HEALTH CARE, INC. -
REGISTERED AGENT ADDRESS CHANGED 1998-02-24 1700 EDUCATION AVE, PUNTA GORDA, FL 33950 -
CHANGE OF PRINCIPAL ADDRESS 1991-12-27 1700 EDUCATION AVENUE, PUNTA GORDA, FL 33950 -
CHANGE OF MAILING ADDRESS 1991-12-27 1700 EDUCATION AVENUE, PUNTA GORDA, FL 33950 -
NAME CHANGE AMENDMENT 1986-12-02 CHARLOTTE COMMUNITY MENTAL HEALTH SERVICES, INC. -

Documents

Name Date
ANNUAL REPORT 2025-01-29
ANNUAL REPORT 2024-02-05
ANNUAL REPORT 2023-01-20
ANNUAL REPORT 2022-04-01
ANNUAL REPORT 2021-01-29
ANNUAL REPORT 2020-01-27
ANNUAL REPORT 2019-02-11
AMENDED ANNUAL REPORT 2018-03-28
ANNUAL REPORT 2018-01-16
ANNUAL REPORT 2017-01-11

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
59-1234922 Corporation Unconditional Exemption 1700 EDUCATION AVE, PUNTA GORDA, FL, 33950-6222 1970-04
In Care of Name -
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Organization that receives a substantial part of its support from a governmental unit or the general public 170(b)(1)(A)(vi)
Tax Period 2024-06
Asset 10,000,000 to 49,999,999
Income 10,000,000 to 49,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Jun
Asset Amount 20503050
Income Amount 21586337
Form 990 Revenue Amount 21586337
National Taxonomy of Exempt Entities -
Sort Name -

Publication 78 Data

Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)

Organization Name CHARLOTTE BEHAVIORAL HEALTH CARE INC
EIN 59-1234922
Tax Period 202306
Filing Type E
Return Type 990
File View File
Organization Name CHARLOTTE BEHAVIORAL HEALTH CARE INC
EIN 59-1234922
Tax Period 202206
Filing Type E
Return Type 990
File View File
Organization Name CHARLOTTE BEHAVIORAL HEALTH CARE INC
EIN 59-1234922
Tax Period 202106
Filing Type E
Return Type 990
File View File
Organization Name CHARLOTTE BEHAVIORAL HEALTH CARE INC
EIN 59-1234922
Tax Period 202006
Filing Type E
Return Type 990
File View File
Organization Name CHARLOTTE BEHAVIORAL HEALTH CARE INC
EIN 59-1234922
Tax Period 201906
Filing Type P
Return Type 990
File View File
Organization Name CHARLOTTE BEHAVIORAL HEALTH CARE INC
EIN 59-1234922
Tax Period 201806
Filing Type P
Return Type 990
File View File
Organization Name CHARLOTTE BEHAVIORAL HEALTH CARE INC
EIN 59-1234922
Tax Period 201706
Filing Type P
Return Type 990
File View File
Organization Name CHARLOTTE BEHAVIORAL HEALTH CARE INC
EIN 59-1234922
Tax Period 201606
Filing Type P
Return Type 990
File View File

Date of last update: 01 Apr 2025

Sources: Florida Department of State