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  5. ELIZABETH H. FAULK FOUNDATION, INC.

ELIZABETH H. FAULK FOUNDATION, INC.

Company Details

Entity Name: ELIZABETH H. FAULK FOUNDATION, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active
Date Filed: 30 Aug 1971 (53 years ago)
Document Number: 721606
FEI/EIN Number 237153172
Address: 22455 BOCA RIO ROAD, BOCA RATON, FL, 33433, US
Mail Address: 22455 BOCA RIO ROAD, BOCA RATON, FL, 33433, US
ZIP code: 33433
County: Palm Beach
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1104068352 2009-04-02 2009-04-02 22455 BOCA RIO RD, BOCA RATON, FL, 334334708, US 22455 BOCA RIO RD, BOCA RATON, FL, 334334708, US

Contacts
Phone +1 561-483-5300
Fax 5614835325

Authorized person
Name DR. HOLLY KATZ
Role PROGRAMS AND TRAINING DIRECTOR
Phone 5614835300

Taxonomy
Taxonomy Code 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center)
Is Primary Yes
Taxonomy Code 261QM0850X - Adult Mental Health Clinic/Center
Is Primary No
Taxonomy Code 261QM0855X - Adolescent and Children Mental Health Clinic/Center
Is Primary No

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FAULK CENTER FOR COUNSELING 2022 237153172 2024-04-08 ELIZABETH H. FAULK FOUNDATION, INC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 624100
Sponsor’s telephone number 5614835300
Plan sponsor’s DBA name FAULK CENTER FOR COUNSELING
Plan sponsor’s address 22455 BOCA RIO ROAD, BOCA RATON, FL, 33433

Plan administrator’s name and address
Administrator’s EIN 237153172
Plan administrator’s name JONATHAN PRICE
Plan administrator’s address 22455 BOCA RIO ROAD, BOCA RATON, FL, 33433
Administrator’s telephone number 5614835300

Signature of
Role Plan administrator
Date 2024-04-08
Name of individual signing JONATHAN PRICE
Valid signature Filed with authorized/valid electronic signature
FAULK CENTER FOR COUNSELING 2021 237153172 2023-04-04 ELIZABETH H. FAULK FOUNDATION, INC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 624100
Sponsor’s telephone number 5614835300
Plan sponsor’s DBA name FAULK CENTER FOR COUNSELING
Plan sponsor’s address 22455 BOCA RIO ROAD, BOCA RATON, FL, 33433

Plan administrator’s name and address
Administrator’s EIN 237153172
Plan administrator’s name JONATHAN PRICE
Plan administrator’s address 22455 BOCA RIO ROAD, BOCA RATON, FL, 33433
Administrator’s telephone number 5614835300

Signature of
Role Plan administrator
Date 2023-04-04
Name of individual signing JONATHAN PRICE
Valid signature Filed with authorized/valid electronic signature
FAULK CENTER FOR COUNSELING 2020 237153172 2021-11-03 ELIZABETH H. FAULK FOUNDATION, INC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 624100
Sponsor’s telephone number 5614835300
Plan sponsor’s DBA name FAULK CENTER FOR COUNSELING
Plan sponsor’s address 22455 BOCA RIO ROAD, BOCA RATON, FL, 33433

Plan administrator’s name and address
Administrator’s EIN 237153172
Plan administrator’s name JONATHAN PRICE
Plan administrator’s address 22455 BOCA RIO ROAD, BOCA RATON, FL, 33433
Administrator’s telephone number 5614835300

Signature of
Role Plan administrator
Date 2021-11-03
Name of individual signing JONATHAN PRICE
Valid signature Filed with authorized/valid electronic signature
FAULK CENTER FOR COUNSELING 2019 237153172 2020-09-30 ELIZABETH H. FAULK FOUNDATION, INC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 624100
Sponsor’s telephone number 5614835300
Plan sponsor’s DBA name FAULK CENTER FOR COUNSELING
Plan sponsor’s address 22455 BOCA RIO ROAD, BOCA RATON, FL, 33433

Plan administrator’s name and address
Administrator’s EIN 237153172
Plan administrator’s name VICKI KATZ
Plan administrator’s address 22455 BOCA RIO ROAD, BOCA RATON, FL, 33433
Administrator’s telephone number 5614835300

Signature of
Role Plan administrator
Date 2020-09-30
Name of individual signing VICKI KATZ
Valid signature Filed with authorized/valid electronic signature
FAULK CENTER FOR COUNSELING 2018 237153172 2020-01-28 ELIZABETH H. FAULK FOUNDATION, INC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 624100
Sponsor’s telephone number 5614835300
Plan sponsor’s DBA name FAULK CENTER FOR COUNSELING
Plan sponsor’s address 22455 BOCA RIO ROAD, BOCA RATON, FL, 33433

Plan administrator’s name and address
Administrator’s EIN 237153172
Plan administrator’s name VICKI KATZ
Plan administrator’s address 22455 BOCA RIO ROAD, BOCA RATON, FL, 33433
Administrator’s telephone number 5614835300

Signature of
Role Plan administrator
Date 2020-01-28
Name of individual signing VICKI KATZ
Valid signature Filed with authorized/valid electronic signature
FAULK CENTER FOR COUNSELING 2017 237153172 2019-01-24 ELIZABETH H. FAULK FOUNDATION, INC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 624100
Sponsor’s telephone number 5614835300
Plan sponsor’s DBA name FAULK CENTER FOR COUNSELING
Plan sponsor’s address 22455 BOCA RIO ROAD, BOCA RATON, FL, 33433

Plan administrator’s name and address
Administrator’s EIN 237153172
Plan administrator’s name VICKI KATZ
Plan administrator’s address 22455 BOCA RIO ROAD, BOCA RATON, FL, 33433
Administrator’s telephone number 5614835300

Signature of
Role Plan administrator
Date 2019-01-24
Name of individual signing VICKI KATZ
Valid signature Filed with authorized/valid electronic signature
FAULK CENTER FOR COUNSELING 2016 237153172 2018-02-08 ELIZABETH H. FAULK FOUNDATION, INC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 624100
Sponsor’s telephone number 5614835300
Plan sponsor’s DBA name FAULK CENTER FOR COUNSELING
Plan sponsor’s address 22455 BOCA RIO ROAD, BOCA RATON, FL, 33433

Plan administrator’s name and address
Administrator’s EIN 237153172
Plan administrator’s name VICKI KATZ
Plan administrator’s address 22455 BOCA RIO ROAD, BOCA RATON, FL, 33433
Administrator’s telephone number 5614835300

Signature of
Role Plan administrator
Date 2018-02-08
Name of individual signing VICKI KATZ
Valid signature Filed with authorized/valid electronic signature
FAULK CENTER FOR COUNSELING 2015 237153172 2017-02-15 ELIZABETH H. FAULK FOUNDATION, INC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 624100
Sponsor’s telephone number 5614835300
Plan sponsor’s DBA name CENTER FOR GROUP COUNSELING
Plan sponsor’s address 22455 BOCA RIO ROAD, BOCA RATON, FL, 33433

Signature of
Role Plan administrator
Date 2017-02-15
Name of individual signing VICKI KATZ
Valid signature Filed with authorized/valid electronic signature
FAULK CENTER FOR COUNSELING 2014 237153172 2016-04-14 ELIZABETH H. FAULK FOUNDATION, INC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 624100
Sponsor’s telephone number 5614835300
Plan sponsor’s DBA name CENTER FOR GROUP COUNSELING
Plan sponsor’s address 22455 BOCA RIO ROAD, BOCA RATON, FL, 33433

Signature of
Role Plan administrator
Date 2016-04-14
Name of individual signing VICKI KATZ
Valid signature Filed with authorized/valid electronic signature
ELIZABETH H FAULK FOUNDATION INC 403B PLAN 2010 237153172 2011-12-06 ELIZABETH H FAULK FOUNDATION INC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 624100
Sponsor’s telephone number 5614835300
Plan sponsor’s DBA name CENTER FOR GROUP COUNSELING
Plan sponsor’s address 22455 BOCA RIO ROAD, BOCA RATON, FL, 33433

Plan administrator’s name and address
Administrator’s EIN 237153172
Plan administrator’s name ELIZABETH H FAULK FOUNDATION INC
Plan administrator’s address 22455 BOCA RIO ROAD, BOCA RATON, FL, 33433
Administrator’s telephone number 5614835300

Signature of
Role Plan administrator
Date 2011-12-06
Name of individual signing VIRGINIA THOFNER
Valid signature Filed with incorrect/unrecognized electronic signature

Agent

Name Role
ELIZABETH H. FAULK FOUNDATION, INC. Agent

Treasurer

Name Role Address
Winter Cindy Treasurer 22455 Boca Rio Road, Boca Raton, FL, 33433

Chief Executive Officer

Name Role Address
Price Jonathan D Chief Executive Officer 22455 Boca Rio Road, Boca Raton, FL, 33433

President

Name Role Address
Collins Gwenesia President 22455 Boca Rio Road, Boca Raton, FL, 33433

Secretary

Name Role Address
BRISSON GENNA M Secretary 22455 Boca Rio Road, BOCA RATON, FL, 33433

Trustee

Name Role Address
Dubow Laurie A Trustee 22455 Boca Rio Road, Boca Raton, FL, 33433

Vice President

Name Role Address
WEISMAN LOIS A Vice President 11062 Boca Woods Lane, Boca Raton, FL, 33428

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G13000010614 FAULK CENTER FOR COUNSELING ACTIVE 2013-01-30 2028-12-31 No data 22455 BOCA RIO ROAD, BOCA RATON, FL, 33433

Events

Event Type Filed Date Value Description
AMENDMENT 2014-07-03 No data No data
REINSTATEMENT 2010-05-10 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2009-09-25 No data No data
AMENDMENT 1997-10-30 No data No data
AMENDMENT 1993-08-30 No data No data

Related by officers

Price Jonathan D

FAULK SENIOR SERVICES, LLC

WEISMAN LOIS A

JWL IN THE ROUGH, INC. WEISMAN REALTY, INC.

Related by address

22455 BOCA RIO ROAD, BOCA RATON, FL, 33433, US

FAULK SENIOR SERVICES, LLC FAULK ENDOWMENT, INC.

22455 BOCA RIO ROAD, BOCA RATON, FL, 33433, US

FAULK SENIOR SERVICES, LLC FAULK ENDOWMENT, INC.

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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