| Entity Name: | PUTNAM COUNTY ALCOHOL AND DRUG COUNCIL, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 30 Jun 1971 (54 years ago) |
| Date of dissolution: | 03 Dec 2012 (12 years ago) |
| Last Event: | VOL DISSOLUTION OF INACTIVE CORP |
| Event Date Filed: | 03 Dec 2012 (12 years ago) |
| Document Number: | 721379 |
| FEI/EIN Number |
591392526
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 330 KAY LARKIN DR, PALATKA, FL, 32177 |
| Mail Address: | 330 KAY LARKIN DR, PALATKA, FL, 32177 |
| ZIP code: | 32177 |
| County: | Putnam |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1023013729 | 2005-06-17 | 2011-12-29 | 330 KAY LARKIN DR, PALATKA, FL, 321772307, US | 330 KAY LARKIN DR, PALATKA, FL, 321772307, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 386-329-3780 |
| Fax | 3863851269 |
Authorized person
| Name | MRS. JOYCE C MILLER |
| Role | CHAIRPERSON BOARD OF DIRECTORS |
| Phone | 3863254714 |
Taxonomy
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
| Taxonomy Code | 324500000X - Substance Abuse Rehabilitation Facility |
| License Number | 0354AD252601 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BC/BS |
| Number | 38327 |
| State | FL |
| Issuer | MEDICAID |
| Number | 360349100 |
| State | FL |
| Issuer | VALUE OPTIONS |
| Number | 335268 |
| State | FL |
| Issuer | MAGELLAN |
| Number | 60023030 |
| State | FL |
| Issuer | MEDICAID CARE MGMT |
| Number | 758545400 |
| State | FL |
| Issuer | WELLCARE |
| Number | 274738 |
| State | FL |
| Issuer | MEDICAID COMP. ACCESS |
| Number | 760471800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BATES BEN | Director | 3400 CRILL AVENUE, PALATKA, FL, 32177 |
| TAYLOR SAMUEL | Director | P.O. BOX 162, EAST PALATKA, FL, 32131 |
| DOUGLAS TAYLOR | Director | 105 SHADY OAK LANE, PALATKA, FL, 32178 |
| SMITH TITO | Director | PO BOX 798, PALATKA, FL, 32177 |
| BROWN LAWSON | Director | 107 S. 9TH ST., PALATKA, FL, 32177 |
| MILLER JOYCE | Agent | 1039 US HWY 17, BOSTWICK, FL, 32007 |
| DRIGGERS STEVE | Director | PO BOX 68, EAST PALATKA, FL, 32131 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOL DISSOLUTION OF INACTIVE CORP | 2012-12-03 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | - | - |
| REGISTERED AGENT ADDRESS CHANGED | 2000-03-24 | 1039 US HWY 17, BOSTWICK, FL 32007 | - |
| CHANGE OF MAILING ADDRESS | 2000-03-24 | 330 KAY LARKIN DR, PALATKA, FL 32177 | - |
| REGISTERED AGENT NAME CHANGED | 2000-03-24 | MILLER, JOYCE | - |
| CHANGE OF PRINCIPAL ADDRESS | 2000-03-24 | 330 KAY LARKIN DR, PALATKA, FL 32177 | - |
| AMENDMENT | 1988-12-23 | - | - |
| AMENDMENT | 1985-11-06 | - | - |
| Name | Date |
|---|---|
| Vol. Diss. of Inactive Corp. | 2012-12-03 |
| ANNUAL REPORT | 2011-02-16 |
| ANNUAL REPORT | 2010-03-09 |
| ANNUAL REPORT | 2009-04-20 |
| ANNUAL REPORT | 2008-07-02 |
| ANNUAL REPORT | 2007-02-23 |
| ANNUAL REPORT | 2006-07-13 |
| ANNUAL REPORT | 2005-04-18 |
| ANNUAL REPORT | 2004-03-02 |
| ANNUAL REPORT | 2003-04-09 |
| FAIN | Awarding Agency | Assistance Listings | Start Date | End Date | Description | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| D04RH12738 | Department of Health and Human Services | 93.912 - RURAL HEALTH CARE SERVICES OUTREACH, RURAL HEALTH NETWORK DEVELOPMENT AND SMALL HEALTH CARE PROVIDER QUALITY IMPROVEMENT PROGRAM | 2009-05-01 | 2012-04-30 | RURAL HEALTH CARE SERVICES OUTREACH GRANT PROGRAM | |||||||||||||||||||||
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Date of last update: 03 Apr 2025
Sources: Florida Department of State
