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  5. NORTHSIDE BEHAVIORAL HEALTH CENTER, INC.

NORTHSIDE BEHAVIORAL HEALTH CENTER, INC. - Florida Company Profile

Company Details

Entity Name: NORTHSIDE BEHAVIORAL HEALTH CENTER, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 11 Dec 1975 (49 years ago)
Last Event: AMENDED AND RESTATED ARTICLES
Event Date Filed: 01 Feb 2021 (4 years ago)
Document Number: 734578
FEI/EIN Number 591641327

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 12512 BRUCE B. DOWNS BLVD., TAMPA, FL, 33612, US
Mail Address: 12512 BRUCE B. DOWNS BLVD., TAMPA, FL, 33612, US
ZIP code: 33612
County: Hillsborough
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1750644811 2012-06-22 2023-08-01 2995 DREW ST FL 2, CLEARWATER, FL, 337593012, US 12512 BRUCE B DOWNS BLVD, TAMPA, FL, 336129209, US

Contacts
Phone +1 727-315-6974
Fax 8136352613
Phone +1 813-977-8700
Fax 8139712029

Authorized person
Name LYNDA GORKEN
Role VICE PRESIDENT
Phone 7272819202

Taxonomy
Taxonomy Code 251B00000X - Case Management Agency
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 117580100
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NORTHSIDE BEHAVIORAL HEALTH CENTER, INC. 2016 591641327 2018-01-12 NORTHSIDE BEHAVIORAL HEALTH CENTER, INC. 129
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1994-07-01
Business code 621420
Sponsor’s telephone number 8139778700
Plan sponsor’s mailing address 12512 BRUCE B. DOWNS BLVD., TAMPA, FL, 33612
Plan sponsor’s address 12512 BRUCE B. DOWNS BLVD., TAMPA, FL, 33612

Number of participants as of the end of the plan year
Active participants 95
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2018-01-12
Name of individual signing KRISTY SMITHWICK
Valid signature Filed with authorized/valid electronic signature
NORTHSIDE BEHAVIORAL HEALTH CENTER, INC. 2015 591641327 2017-04-17 NORTHSIDE BEHAVIORAL HEALTH CENTER, INC. 127
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1994-07-01
Business code 621420
Sponsor’s telephone number 8139778700
Plan sponsor’s mailing address 12512 BRUCE B DOWNS BLVD, TAMPA, FL, 336129209
Plan sponsor’s address 12512 BRUCE B DOWNS BLVD, TAMPA, FL, 336129209

Number of participants as of the end of the plan year
Active participants 118
Retired or separated participants receiving benefits 2
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2017-04-17
Name of individual signing ELAINE CHURTON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-04-17
Name of individual signing ELAINE CHURTON
Valid signature Filed with authorized/valid electronic signature
NORTHSIDE BEHAVIORAL HEALTH CENTER, INC. 2014 591641327 2016-03-03 NORTHSIDE BEHAVIORAL HEALTH CENTER, INC. 141
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1994-07-01
Business code 621420
Sponsor’s telephone number 8139778700
Plan sponsor’s mailing address 12512 BRUCE B. DOWNS BLVD., TAMPA, FL, 33612
Plan sponsor’s address 12512 BRUCE B. DOWNS BLVD., TAMPA, FL, 33612

Number of participants as of the end of the plan year
Active participants 129
Retired or separated participants receiving benefits 1
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2016-03-03
Name of individual signing GLEN BLONQUIST
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-03-03
Name of individual signing GLEN BLONQUIST
Valid signature Filed with authorized/valid electronic signature
NORTHSIDE BEHAVIORAL HEALTH CENTER, INC. 2013 591641327 2015-03-04 NORTHSIDE BEHAVIORAL HEALTH CENTER, INC. 169
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1994-07-01
Business code 621420
Sponsor’s telephone number 8139778700
Plan sponsor’s mailing address 12512 BRUCE B. DOWNS BLVD., TAMPA, FL, 33612
Plan sponsor’s address 12512 BRUCE B. DOWNS BLVD., TAMPA, FL, 33612

Number of participants as of the end of the plan year
Active participants 139
Retired or separated participants receiving benefits 3
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2015-03-04
Name of individual signing GLEN BLONQUIST
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-03-04
Name of individual signing GLEN BLONQUIST
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
Galdieri Lou Chairman 2985 Drew Street, Clearwater, FL, 33759
Ryder Gail Vice President 2985 Drew Street, Clearwater, FL, 33759
Beamon Ron Treasurer 2985 Drew Street, Clearwater, FL, 33759
BAYCARE HEALTH SYSTEM, INC. Agent -

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2023-04-21 BAYCARE HEALTH SYSTEM, INC. -
REGISTERED AGENT ADDRESS CHANGED 2023-04-21 2985 Drew Street, Clearwater, FL 33759 -
AMENDED AND RESTATEDARTICLES 2021-02-01 - -
NAME CHANGE AMENDMENT 2014-08-22 NORTHSIDE BEHAVIORAL HEALTH CENTER, INC. -
NAME CHANGE AMENDMENT 1995-02-06 NORTHSIDE MENTAL HEALTH CENTER, INC. -
CHANGE OF PRINCIPAL ADDRESS 1993-09-22 12512 BRUCE B. DOWNS BLVD., TAMPA, FL 33612 -
CHANGE OF MAILING ADDRESS 1993-09-22 12512 BRUCE B. DOWNS BLVD., TAMPA, FL 33612 -
NAME CHANGE AMENDMENT 1993-07-07 NORTHSIDE MENTAL HEALTH HOSPITAL, INCORPORATED -
NAME CHANGE AMENDMENT 1986-04-25 NORTHSIDE CENTERS, INCORPORATED -
AMENDMENT 1986-04-23 - -

Documents

Name Date
ANNUAL REPORT 2024-04-01
ANNUAL REPORT 2023-04-21
ANNUAL REPORT 2022-02-22
ANNUAL REPORT 2021-07-27
DR. SUSAN HOERBELT 2021-02-01
ANNUAL REPORT 2020-03-17
ANNUAL REPORT 2019-02-12
ANNUAL REPORT 2018-03-21
ANNUAL REPORT 2017-04-18
ANNUAL REPORT 2016-03-21

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
59-1641327 Corporation Unconditional Exemption 12512 BRUCE B DOWNS BLVD, TAMPA, FL, 33612-9209 1982-02
In Care of Name -
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Educational Organization, Local Association of Employees, Agricultural Organization, Horticultural Organization, Board of Trade, Business League, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Voluntary Employees' Beneficiary Association (Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Mutual Ditch or Irrigation Co., Burial Association, Cemetery Company, Credit Union, Other Mutual Corp. or Assoc., Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Hospital or medical research organization 170(b)(1)(A)(iii)
Tax Period 2023-12
Asset 5,000,000 to 9,999,999
Income 10,000,000 to 49,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 5846232
Income Amount 13850759
Form 990 Revenue Amount 13850759
National Taxonomy of Exempt Entities -
Sort Name -

Publication 78 Data
Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name NORTHSIDE BEHAVIORAL HEALTH CENTER INC
EIN 59-1641327
Tax Period 202206
Filing Type E
Return Type 990
File View File
Organization Name NORTHSIDE BEHAVIORAL HEALTH CENTER INC
EIN 59-1641327
Tax Period 202106
Filing Type E
Return Type 990
File View File
Organization Name NORTHSIDE BEHAVIORAL HEALTH CENTER INC
EIN 59-1641327
Tax Period 202006
Filing Type E
Return Type 990
File View File
Organization Name NORTHSIDE BEHAVIORAL HEALTH CENTER INC
EIN 59-1641327
Tax Period 201906
Filing Type E
Return Type 990
File View File
Organization Name NORTHSIDE BEHAVIORAL HEALTH CENTER INC
EIN 59-1641327
Tax Period 201806
Filing Type E
Return Type 990
File View File
Organization Name NORTHSIDE BEHAVIORAL HEALTH CENTER INC
EIN 59-1641327
Tax Period 201706
Filing Type E
Return Type 990
File View File
Organization Name NORTHSIDE BEHAVIORAL HEALTH CENTER INC
EIN 59-1641327
Tax Period 201606
Filing Type E
Return Type 990
File View File

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
1602027100 2020-04-10 0455 PPP 12512 Bruce B Downs Blvd, TAMPA, FL, 33612-9209
Loan Status Date 2021-04-22
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 1046600
Loan Approval Amount (current) 1046600
Undisbursed Amount 0
Franchise Name -
Lender Location ID 123499
Servicing Lender Name BayFirst National Bank
Servicing Lender Address 700 Central Avenue, Saint Petersburg, FL, 33701
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address TAMPA, HILLSBOROUGH, FL, 33612-9209
Project Congressional District FL-15
Number of Employees 179
NAICS code 621420
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 123499
Originating Lender Name BayFirst National Bank
Originating Lender Address Saint Petersburg, FL
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 1055632.3
Forgiveness Paid Date 2021-03-22

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Ryder Gail

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Beamon Ron

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BAYCARE HEALTH SYSTEM, INC.

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Companies related by address

No other companies in our directory share the same address as NORTHSIDE BEHAVIORAL HEALTH CENTER, INC.

Date of last update: 03 Apr 2025

Sources: Florida Department of State

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