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  5. COLUMBIA COUNTY SENIOR SERVICES, INC.

COLUMBIA COUNTY SENIOR SERVICES, INC.

Company Details

Entity Name: COLUMBIA COUNTY SENIOR SERVICES, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active
Date Filed: 07 Jul 1972 (53 years ago)
Document Number: 723834
FEI/EIN Number 591447549
Address: 628 SE ALLISON COURT, LAKE CITY, FL, 32025, US
Mail Address: P O Box 1772, LAKE CITY, FL, 32056, US
ZIP code: 32025
County: Columbia
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1528794732 2022-07-29 2023-07-24 PO BOX 1772, LAKE CITY, FL, 320561772, US 628 SE ALLISON CT, LAKE CITY, FL, 320256101, US

Contacts
Phone +1 386-755-0235

Authorized person
Name DAVID T HUCKABEE
Role EXECUTIVE DIRECTOR
Phone 3867550235

Taxonomy
Taxonomy Code 253Z00000X - In Home Supportive Care Agency
Is Primary No
Taxonomy Code 261QA0600X - Adult Day Care Clinic/Center
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 113652900
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
COLUMBIA COUNTY SEINOR SERVICES 457 DEFERRED COMPENSATION 2023 591447549 2024-10-22 COLUMBIA COUNTY SENIOR SERVICES ,INC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 624100
Sponsor’s telephone number 3867550235
Plan sponsor’s address PO BOX 1772, LAKE CITY, FL, 320561772

Signature of
Role Plan administrator
Date 2024-10-15
Name of individual signing DAVID HUCKABEE
Valid signature Filed with authorized/valid electronic signature
COLUMBIA COUNTY SEINOR SERVICES 457 DEFERRED COMPENSATION 2022 591447549 2023-10-13 COLUMBIA COUNTY SENIOR SERVICES ,INC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 624100
Sponsor’s telephone number 3867550235
Plan sponsor’s address PO BOX 1772, LAKE CITY, FL, 320561772

Signature of
Role Plan administrator
Date 2023-10-13
Name of individual signing DAVID HUCKABEE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-10-13
Name of individual signing DAVID HUCKABEE
Valid signature Filed with authorized/valid electronic signature
COLUMBIA COUNTY SENIOR SERVICES 457 DEFERRED COMPENSATION 2021 591447549 2022-10-12 COLUMBIA COUNTY SENIOR SERVICES, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 624100
Sponsor’s telephone number 3867550235
Plan sponsor’s address PO BOX 1772, LAKE CITY, FL, 320561772

Signature of
Role Plan administrator
Date 2022-10-12
Name of individual signing DAVID HUCKABEE
Valid signature Filed with authorized/valid electronic signature
COLUMBIA COUNTY SENIOR SERVICES 457 DEFERRED COMPENSATION 2020 591447549 2021-08-12 COLUMBIA COUNTY SENIOR SERVICES, INC. 5
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 624100
Sponsor’s telephone number 3867550235
Plan sponsor’s address PO BOX 1772, LAKE CITY, FL, 320561772
COLUMBIA COUNTY SENIOR SERVICES 457 DEFERRED COMPENSATION 2020 591447549 2021-08-12 COLUMBIA COUNTY SENIOR SERVICES, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 624100
Sponsor’s telephone number 3867550235
Plan sponsor’s address PO BOX 1772, LAKE CITY, FL, 320561772

Signature of
Role Plan administrator
Date 2021-08-12
Name of individual signing VANESSA LAWTON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-08-12
Name of individual signing VANESSA LAWTON
Valid signature Filed with authorized/valid electronic signature
COLUMBIA COUNTY SENIOR SERVICES 457 DEFERRED COMPENSATION 2020 591447549 2021-08-12 COLUMBIA COUNTY SENIOR SERVICES, INC. 5
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 624100
Sponsor’s telephone number 3867550235
Plan sponsor’s address PO BOX 1772, LAKE CITY, FL, 320561772

Signature of
Role Employer/plan sponsor
Date 2021-08-12
Name of individual signing VANESSA LAWTON
Valid signature Filed with authorized/valid electronic signature
COLUMBIA COUNTY SENIOR SERVICES 457 DEFERRED COMPENSATION 2020 591447549 2021-08-12 COLUMBIA COUNTY SENIOR SERVICES, INC. 5
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 624100
Sponsor’s telephone number 3867550235
Plan sponsor’s address PO BOX 1772, LAKE CITY, FL, 320561772

Signature of
Role Employer/plan sponsor
Date 2021-08-12
Name of individual signing VANESSA LAWTON
Valid signature Filed with authorized/valid electronic signature
COLUMBIA COUNTY SENIOR SERVICES 457 DEFERRED COMPENSATION 2019 591447549 2020-10-08 COLUMBIA COUNTY SENIOR SERVICES, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 624100
Sponsor’s telephone number 3867550235
Plan sponsor’s address PO BOX 1772, LAKE CITY, FL, 320561772

Signature of
Role Plan administrator
Date 2020-10-08
Name of individual signing VANESSA LAWTON
Valid signature Filed with authorized/valid electronic signature
COLUMBIA COUNTY SENIOR SERVICES 457 DEFERRED COMPENSATION 2018 591447549 2019-07-12 COLUMBIA COUNTY SENIOR SERVICES, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 624100
Sponsor’s telephone number 3867550235
Plan sponsor’s address PO BOX 1772, LAKE CITY, FL, 320561772

Signature of
Role Plan administrator
Date 2019-07-12
Name of individual signing DEBORAH FREEMAN
Valid signature Filed with authorized/valid electronic signature
COLUMBIA COUNTY SENIOR SERVICES 457 DEFERRED COMPENSATION 2017 591447549 2018-10-11 COLUMBIA COUNTY SENIOR SERVICES, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 624100
Sponsor’s telephone number 3867550235
Plan sponsor’s address PO BOX 1772, LAKE CITY, FL, 320561772

Signature of
Role Plan administrator
Date 2018-10-11
Name of individual signing DEBORAH FREEMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-11
Name of individual signing DEBORAH FREEMAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Huckabee David Agent 628 SE Allison Court, LAKE CITY, FL, 32025

Secretary

Name Role Address
Williams Renee Secretary 628 SE Allison Court, LAKE CITY, FL, 32025

Treasurer

Name Role Address
Pinchouck Lee Treasurer 628 SE Allison CT, LAKE CITY, FL, 32025

Executive Director

Name Role Address
Huckabee David Executive Director 628 SE ALLISON COURT, LAKE CITY, FL, 32025

Vice President

Name Role Address
Epperson Alisa Vice President 628 SE ALLISON CT, LAKE CITY, FL, 32025

President

Name Role Address
Lunde Stephanie President 628 SE Allison Court, Lake City, FL, 32025

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G13000043425 THE CLUB EXPIRED 2013-05-06 2018-12-31 No data P.O. BOX 1772, LAKE CITY, FL, 32056

Events

Event Type Filed Date Value Description
NAME CHANGE AMENDMENT 1997-03-26 COLUMBIA COUNTY SENIOR SERVICES, INC. No data

Related by officers

Williams Renee

STYLO DOWN TO EARTH RECORDS LLC LAKE CITY ELKS CLUB, INC.

Huckabee David

A 2 Z OF LAKE CITY, INC.

Lunde Stephanie

A 2 Z OF LAKE CITY, INC.

Related by address

628 SE ALLISON COURT, LAKE CITY, FL, 32025, US

A 2 Z OF LAKE CITY, INC.

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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