| Entity Name: | FLORIDA COMMUNITY HEALTH CENTERS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 14 Jun 1976 (49 years ago) |
| Document Number: | 736086 |
| FEI/EIN Number | 591671640 |
| Address: | 5827 CORPORATE WAY, WEST PALM BEACH, FL, 33407, US |
| Mail Address: | 5827 CORPORATE WAY, WEST PALM BEACH, FL, 33407, US |
| ZIP code: | 33407 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669191755 | 2022-08-23 | 2022-08-23 | 5827 CORPORATE WAY, WEST PALM BEACH, FL, 334072000, US | 941 SE 1ST ST, BELLE GLADE, FL, 334304353, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 561-844-9443 |
| Fax | 5618441013 |
Authorized person
| Name | WILHELMINA N. LEWIS |
| Role | CEO |
| Phone | 5618449443 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | No |
| Taxonomy Code | 261QF0400X - Federally Qualified Health Center (FQHC) |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FLORIDA COMMUNITY HEALTH CENTERS, INC. RETIREMENT PLAN | 2014 | 591671640 | 2015-07-31 | FLORIDA COMMUNITY HEALTH CENTERS, INC | 293 | |||||||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||||||||
| Active participants | 269 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 54 |
| Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 0 |
| Number of participants with account balances as of the end of the plan year | 319 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 13 |
Signature of
| Role | Plan administrator |
| Date | 2015-07-31 |
| Name of individual signing | KATHY AMATO |
| Valid signature | Filed with authorized/valid electronic signature |
| Three-digit plan number (PN) | 501 |
| Effective date of plan | 1992-04-01 |
| Business code | 621498 |
| Sponsor’s telephone number | 5618449443 |
| Plan sponsor’s mailing address | 4450 S TIFFANY DR, WEST PALM BEACH, FL, 33407 |
| Plan sponsor’s address | 4450 S TIFFANY DR, WEST PALM BEACH, FL, 33407 |
Plan administrator’s name and address
| Administrator’s EIN | 591671640 |
| Plan administrator’s name | FLORIDA COMMUNITY HEALTH CENTERS INC |
| Plan administrator’s address | 4450 S TIFFANY DR, WEST PALM BEACH, FL, 33407 |
| Administrator’s telephone number | 5618449443 |
Number of participants as of the end of the plan year
| Active participants | 206 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 0 |
Signature of
| Role | Employer/plan sponsor |
| Date | 2011-03-21 |
| Name of individual signing | DONNA HOLM |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 501 |
| Effective date of plan | 1992-04-01 |
| Business code | 621498 |
| Sponsor’s telephone number | 5618449443 |
| Plan sponsor’s mailing address | 4450 S TIFFANY DR, WEST PALM BEACH, FL, 33407 |
| Plan sponsor’s address | 4450 S TIFFANY DR, WEST PALM BEACH, FL, 33407 |
Plan administrator’s name and address
| Administrator’s EIN | 591671640 |
| Plan administrator’s name | FLORIDA COMMUNITY HEALTH CENTERS INC |
| Plan administrator’s address | 4450 S TIFFANY DR, WEST PALM BEACH, FL, 33407 |
| Administrator’s telephone number | 5618449443 |
Number of participants as of the end of the plan year
| Active participants | 206 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 0 |
Signature of
| Role | Plan administrator |
| Date | 2011-03-21 |
| Name of individual signing | DONNA HOLM |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Lewis Wilhelmina Dr. | Agent | 5827 CORPORATE WAY, WEST PALM BEACH, FL, 33407 |
| Name | Role | Address |
|---|---|---|
| LEWIS WILHELMINA Dr. | Chief Executive Officer | 5827 Corporate Way, West Palm Beach, FL, 33407 |
| Name | Role | Address |
|---|---|---|
| RUCKS BRIAN | Treasurer | 15690 SW WARFIELD BLVD, INDIANTOWN, FL, 34956 |
| Name | Role | Address |
|---|---|---|
| Cotton Karen | Secretary | 3617 S.W. 17th Street, Okeechobee, FL, 34974 |
| Name | Role | Address |
|---|---|---|
| Mills Kenneth | Chairman | 1330 S.W. Briarwood Drive, Port Saint Lucie, FL, 34986 |
| Name | Role | Address |
|---|---|---|
| Delancy Eutris | Director | 4174 S.W. Darien Street, Port Saint Lucie, FL, 34953 |
| TAYLOR JANET | Director | P.O. BOX 764, CLEWISTON, FL, 33440 |
| Name | Role | Address |
|---|---|---|
| LEWIS WILHELMINA Dr. | President | 5827 Corporate Way, West Palm Beach, FL, 33407 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| NAME CHANGE AMENDMENT | 1977-05-26 | FLORIDA COMMUNITY HEALTH CENTERS, INC. | No data |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
