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COASTAL BEHAVIORAL HEALTHCARE, INC.

COASTAL BEHAVIORAL HEALTHCARE, INC.

Company Details

Entity Name:	COASTAL BEHAVIORAL HEALTHCARE, INC.
Jurisdiction:	FLORIDA
Filing Type:	Florida Not For Profit Corporation
Status:	Inactive
Date Filed:	02 Jan 1973 (52 years ago)
Date of dissolution:	23 Sep 2022 (2 years ago)
Last Event:	ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed:	23 Sep 2022 (2 years ago)
Document Number:	725154
FEI/EIN Number	59-1432136
Address:	4579 Northgate Ct, SARASOTA, FL 34234
Mail Address:	P. O. BOX 1599, SARASOTA, FL 34230
ZIP code:	34234
County:	Sarasota
Place of Formation:	FLORIDA

National Provider Identifier

NPI

Enumeration Date

Last Update Date

Mailing Address

Practice Location Address

1598726648

2006-03-29

2020-09-09

4579 NORTHGATE CT, SARASOTA, FL, 342342124, US

Contacts

Phone	+1 941-366-5333
Fax	9419276315
Phone	+1 941-927-8900
Fax	9413082931

Authorized person

Name	CAROL HABERMEHL
Role	BILLING/CLAIMS/MANAGEDCARE DIRECTOR
Phone	9413312530

Taxonomy

Taxonomy Code	251B00000X - Case Management Agency
Is Primary	No
Taxonomy Code	251S00000X - Community/Behavioral Health Agency
Is Primary	Yes
Taxonomy Code	251S00000X - Community/Behavioral Health Agency
License Number	1423
State	FL
Is Primary	No
Taxonomy Code	323P00000X - Psychiatric Residential Treatment Facility
Is Primary	No

Other Provider Identifiers

Issuer	MEDICAID
Number	060975721
State	FL
Issuer	MEDICAID
Number	060975728
State	FL
Issuer	MEDICAID
Number	060975700
State	FL
Issuer	MEDICAID
Number	060975725
State	FL
Issuer	MEDICAID
Number	060975716
State	FL
Issuer	MEDICAID
Number	060975717
State	FL
Issuer	MEDICAID
Number	060975726
State	FL
Issuer	MEDICAID
Number	060975720
State	FL
Issuer	MEDICAID
Number	060975715
State	FL
Issuer	MEDICAID
Number	060975722
State	FL
Issuer	MEDICAID
Number	060975741
State	FL

Legal Entity Identifier

LEI number

Registered As

Jurisdiction Of Formation

General Category

Entity Status

Entity created at

549300IJ913Z8O0B2S29

725154

US-FL

GENERAL

ACTIVE

No data

Addresses

Legal	C/O Radcliffe, Joanne M, 1565 State Street, Sarasota, US-FL, US, 34236
Headquarters	1565 State Street, Sarasota, US-FL, US, 34236

Registration details

Registration Date	2013-12-19
Last Update	2023-08-04
Status	LAPSED
Next Renewal	2014-12-16
LEI Issuer	5493001KJTIIGC8Y1R12
Corroboration Level	FULLY_CORROBORATED
Data Validated As	725154

Agent

Name	Role	Address
Tiutyama, Victoria	Agent	4579 Northgate Ct, SARASOTA, FL 34234

President

Name	Role	Address
Tiutyama, Victoria	President	4579 Northgate Ct, SARASOTA, FL 34234

Chief Executive Officer

Name	Role	Address
Tiutyama, Victoria	Chief Executive Officer	4579 Northgate Ct, SARASOTA, FL 34234

Chief Financial Officer

Name	Role	Address
Tiutyama, Victoria	Chief Financial Officer	4579 Northgate Ct, SARASOTA, FL 34234

Chairman

Name	Role	Address
Dudley, Carson	Chairman	5700 Midnight Pass Rd, 4A Sarasota, FL 34242

Secretary

Name	Role	Address
Miller, Jay	Secretary	800 S. Osprey Ave, Sarasota, FL 34236

Treasurer

Name	Role	Address
Miller, Jay	Treasurer	800 S. Osprey Ave, Sarasota, FL 34236

Director

Name	Role	Address
Alexander, Ken	Director	2180 Tall Oak Court, Sarasota, FL 34232

Events

Event Type	Filed Date	Value	Description
ADMIN DISSOLUTION FOR ANNUAL REPORT	2022-09-23	No data	No data
CHANGE OF PRINCIPAL ADDRESS	2020-04-23	4579 Northgate Ct, SARASOTA, FL 34234	No data
REGISTERED AGENT ADDRESS CHANGED	2020-04-23	4579 Northgate Ct, SARASOTA, FL 34234	No data
REGISTERED AGENT NAME CHANGED	2020-04-23	Tiutyama, Victoria	No data
AMENDMENT	2019-11-13	No data	No data
AMENDMENT	2011-02-03	No data	No data
CHANGE OF MAILING ADDRESS	2004-02-03	4579 Northgate Ct, SARASOTA, FL 34234	No data
NAME CHANGE AMENDMENT	2001-12-05	COASTAL BEHAVIORAL HEALTHCARE, INC.	No data
AMENDMENT	1990-09-04	No data	No data
NAME CHANGE AMENDMENT	1988-12-30	COASTAL RECOVERY CENTERS, INC.	No data
REINSTATEMENT	1985-02-06	No data	No data
NAME CHANGE AMENDMENT	1985-02-06	STOREFRONT CENTERS FOR COUNSELING, INC.	No data
CANCEL FOR NON-PAYMENT	1976-09-03	No data	No data

Court Cases

Title

Case Number

Docket Date

Status

LAWRENCE GUDMESTAD VS COASTAL BEHAVIORAL HEALTHCARE, INC. AND THOMAS M. KNIGHT, SHERIFF OF SARASOTA COUNTY

2D2018-3791

2018-09-21

Closed

Classification	Original Proceedings - Circuit Criminal - Habeas Corpus
Court	2nd District Court of Appeal
Originating Court	Circuit Court for the Twelfth Judicial Circuit, Sarasota County 2013-CF-949

Parties

Name	LAWRENCE GUDMESTAD
Role	Petitioner
Status	Active
Representations	JOHN TORRACO, ESQ.

Name	COASTAL BEHAVIORAL HEALTHCARE, INC.
Role	Respondent
Status	Active
Representations	Katie Lynn Salemi - Ashby, A.A.G., CRYSTAL BAILEY, ESQ., Attorney General, Tampa

Name	THOMAS M. KNIGHT, SHERIFF
Role	Respondent
Status	Active

Name	HON. STEPHEN WALKER
Role	Judge/Judicial Officer
Status	Active

Name	HONORABLE LYNN N. SILVERTOOTH
Role	Judge/Judicial Officer
Status	Active

Name	SARASOTA CLERK
Role	Lower Tribunal Clerk
Status	Active

Docket Entries

Docket Date	2018-11-07
Type	Misc. Events
Subtype	Case Closed
Description	Case Closed

Docket Date	2018-10-08
Type	Disposition
Subtype	Denied
Description	Denied - Order by Judge ~ LaRose, C.J., and Morris and Salario

Docket Date	2018-10-08
Type	Disposition by Order
Subtype	Denied
Description	denial of habeas corpus ~ Petitioner's petition for writ of habeas corpus is denied as moot.

Docket Date	2018-10-01
Type	Response
Subtype	Reply
Description	REPLY ~ PETITIONER'S REPLY FOR WRIT OF HABEAS CORPUS, OR IN THE ALTERNATIVE WRIT OF CERTIORARI
On Behalf Of	LAWRENCE GUDMESTAD

Docket Date	2018-09-28
Type	Notice
Subtype	Notice of Supplemental Authority
Description	Notice of Supplemental Authority
On Behalf Of	LAWRENCE GUDMESTAD

Docket Date	2018-09-28
Type	Response
Subtype	Response
Description	RESPONSE ~ RESPONSE TO PETITION FOR WRIT OF HABEAS CORPUS OR, IN THEALTERNATIVE, PETITION FOR WRIT OF CERTIORARI
On Behalf Of	COASTAL BEHAVIORAL HEALTHCARE, INC.

Docket Date	2018-09-28
Type	Record
Subtype	Appendix to Response
Description	APPENDICES /ATTACHMENTS TO RESPONSE ~ APPENDIX TO RESPONSE TO PETITION FOR WRIT OF HABEAS CORPUS OR, IN THE ALTERNATIVE, PETITION FOR WRIT OF CERTIORARI
On Behalf Of	COASTAL BEHAVIORAL HEALTHCARE, INC.

Docket Date	2018-09-21
Type	Record
Subtype	Appendix
Description	ORIGINAL APPENDIX OR ATTACHMENT
On Behalf Of	LAWRENCE GUDMESTAD

Docket Date	2018-09-21
Type	Petition
Subtype	Petition
Description	Petition Filed
On Behalf Of	LAWRENCE GUDMESTAD

Docket Date	2018-09-21
Type	Misc. Events
Subtype	Fee Status
Description	NF4:No Fee-Habeas Corpus

Docket Date	2018-09-21
Type	Letter
Subtype	Acknowledgment Letter
Description	Acknowledgment Letter 1

Docket Date	2018-09-21
Type	Order
Subtype	Quick Response to Habeas by AG
Description	quick response to habeas by AG ~ The Attorney General shall file and serve a response to the petition for writ of habeas corpus or in the alternative writ of certiorari on or before September 28, 2018. The petitioner may file a reply within three days of service of the response. Any electronic filing shall be designated as an emergency by checking the box for this purpose.

Documents

Name	Date
ANNUAL REPORT	2021-03-24
ANNUAL REPORT	2020-04-23
Amendment	2019-11-13
ANNUAL REPORT	2019-01-29
ANNUAL REPORT	2018-01-17
ANNUAL REPORT	2017-01-13
ANNUAL REPORT	2016-03-28
ANNUAL REPORT	2015-03-04
ANNUAL REPORT	2014-03-18
AMENDED ANNUAL REPORT	2013-05-14
ANNUAL REPORT	2013-01-24
Reg. Agent Change	2012-06-18
ANNUAL REPORT	2012-01-04
Amendment	2011-02-03
ANNUAL REPORT	2011-01-04
ANNUAL REPORT	2010-01-07
ANNUAL REPORT	2009-01-14
ANNUAL REPORT	2008-01-03
ANNUAL REPORT	2007-01-04
ANNUAL REPORT	2006-01-26

Date of last update: 06 Feb 2025

Sources: Florida Department of State