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  5. LA AMISTAD FOUNDATION, INC.

LA AMISTAD FOUNDATION, INC.

Company Details

Entity Name: LA AMISTAD FOUNDATION, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active
Date Filed: 18 Feb 1970 (55 years ago)
Document Number: 718090
FEI/EIN Number 591300982
Address: 8400 LA AMISTAD COVE, FERN PARK, FL, 32730, US
Mail Address: 8400 LA AMISTAD COVE, FERN PARK, FL, 32730, US
ZIP code: 32730
County: Seminole
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1710150834 2008-04-09 2008-04-09 8400 LA AMISTAD CV, FERN PARK, FL, 327302900, US 8400 LA AMISTAD CV, FERN PARK, FL, 327302900, US

Contacts
Phone +1 407-332-1711
Fax 4073317291

Authorized person
Name MS. HELEN BOOTH
Role PRESIDENT/CEO
Phone 4073321711

Taxonomy
Taxonomy Code 323P00000X - Psychiatric Residential Treatment Facility
License Number 8569
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LA AMISTAD FOUNDATION RETIREMENT SAVINGS PLAN 2023 591300982 2024-07-12 LA AMISTAD FOUNDATION INC 49
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 623000
Sponsor’s telephone number 4073321711
Plan sponsor’s address 8400 LA AMISTAD COVE, FERN PARK, FL, 32730

Signature of
Role Plan administrator
Date 2024-07-12
Name of individual signing SARAH SUMMEY
Valid signature Filed with authorized/valid electronic signature
LA AMISTAD FOUNDATION RETIREMENT SAVINGS PLAN 2022 591300982 2023-10-09 LA AMISTAD FOUNDATION INC 51
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 623000
Sponsor’s telephone number 4073321711
Plan sponsor’s address 8400 LA AMISTAD COVE, FERN PARK, FL, 32730

Signature of
Role Plan administrator
Date 2023-10-09
Name of individual signing SARAH SUMMEY
Valid signature Filed with authorized/valid electronic signature
LA AMISTAD FOUNDATION RETIREMENT SAVINGS PLAN 2021 591300982 2022-07-20 LA AMISTAD FOUNDATION INC 53
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 623000
Sponsor’s telephone number 4073321711
Plan sponsor’s address 8400 LA AMISTAD COVE, FERN PARK, FL, 32730

Signature of
Role Plan administrator
Date 2022-07-20
Name of individual signing CARLTON TALLEY
Valid signature Filed with authorized/valid electronic signature
LA AMISTAD FOUNDATION RETIREMENT SAVINGS PLAN 2021 591300982 2022-07-20 LA AMISTAD FOUNDATION INC 53
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 623000
Sponsor’s telephone number 4073321711
Plan sponsor’s address 8400 LA AMISTAD COVE, FERN PARK, FL, 32730

Signature of
Role Plan administrator
Date 2022-07-20
Name of individual signing CARLTON TALLEY
Valid signature Filed with authorized/valid electronic signature
LA AMISTAD FOUNDATION RETIREMENT SAVINGS PLAN 2020 591300982 2021-10-05 LA AMISTAD FOUNDATION INC 54
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 623000
Sponsor’s telephone number 4073321711
Plan sponsor’s address 8400 LA AMISTAD COVE, FERN PARK, FL, 32730

Signature of
Role Plan administrator
Date 2021-10-05
Name of individual signing CARLTON TALLEY
Valid signature Filed with authorized/valid electronic signature
LA AMISTAD FOUNDATION RETIREMENT SAVINGS PLAN 2019 591300982 2020-07-15 LA AMISTAD FOUNDATION INC. 51
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 623000
Sponsor’s telephone number 4073321711
Plan sponsor’s address 8400 LA AMISTAD COVE, FERN PARK, FL, 32730

Signature of
Role Plan administrator
Date 2020-07-15
Name of individual signing JAKE TALLEY
Valid signature Filed with authorized/valid electronic signature
LA AMISTAD FOUNDATION RETIREMENT SAVINGS PLAN 2018 591300982 2019-07-03 LA AMISTAD FOUNDATION INC. 51
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 623000
Sponsor’s telephone number 4073321711
Plan sponsor’s address 8400 LA AMISTAD COVE, FERN PARK, FL, 32730

Signature of
Role Plan administrator
Date 2019-07-03
Name of individual signing CARLTON TALLEY
Valid signature Filed with authorized/valid electronic signature
LA AMISTAD FOUNDATION RETIREMENT SAVINGS PLAN 2017 591300982 2018-07-26 LA AMISTAD FOUNDATION INC 37
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 623000
Sponsor’s telephone number 4073321711
Plan sponsor’s address 8400 LA AMISTAD COVE, FERN PARK, FL, 32730

Signature of
Role Plan administrator
Date 2018-07-26
Name of individual signing CARLTON TALLEY
Valid signature Filed with authorized/valid electronic signature
LA AMISTAD FOUNDATION RETIREMENT SAVINGS PLAN 2016 591300982 2017-08-10 LA AMISTAD FOUNDATION INC 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 623000
Sponsor’s telephone number 4073321711
Plan sponsor’s address 8400 LA AMISTAD COVE, FERN PARK, FL, 32730

Signature of
Role Plan administrator
Date 2017-08-10
Name of individual signing CARLTON TALLEY
Valid signature Filed with authorized/valid electronic signature
LA AMISTAD FOUNDATION RETIREMENT SAVINGS PLAN 2015 591300982 2016-10-12 LA AMISTAD FOUNDATION INC 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 623000
Sponsor’s telephone number 4073321711
Plan sponsor’s address 8400 LA AMISTAD COVE, FERN PARK, FL, 32730

Signature of
Role Plan administrator
Date 2016-10-12
Name of individual signing HELEN BOOTH
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Summey Sarah Agent 497 Buckhorn Drive, Winter Springs, FL, 32708

Trustee

Name Role Address
Higgins Stephanie Trustee 1321 W Harvard St, Orlando, FL, 32804
MOORE NOELLE Trustee 608 Waverly Lane, Maitland, FL, 32751
Smith Jordan Trustee 204 Hurst Court, Lake Mary, FL, 32746
Auld Bryn Trustee 1667 Lasbury Ave., Winter Park, FL, 32789

Chairman

Name Role Address
WILLIAMS TERESA Chairman 1450 Chestnut Ave, WINTER PARK, FL, 32789

Secretary

Name Role Address
WOODRUFF BRUCE Secretary 3101 Maguire Blvd, Ste. 256, Orlando, FL, 32803

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G04023900237 LAKEWOOD CENTER ACTIVE 2004-01-23 2025-12-31 No data 8400 LA AMISTAD COVE, FERN PARK, FL, 32730

Events

Event Type Filed Date Value Description
REINSTATEMENT 2017-10-23 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2017-09-22 No data No data
REINSTATEMENT 1997-12-01 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 1997-09-26 No data No data
NAME CHANGE AMENDMENT 1974-11-18 LA AMISTAD FOUNDATION, INC. No data

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Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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