| Entity Name: | THE KATHLEEN ANDERSON COMPREHENSIVE WORK CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 15 Jun 1978 (47 years ago) |
| Document Number: | 743261 |
| FEI/EIN Number | 591897707 |
| Address: | 1095 BELLE AVE., CASSELBERRY, FL, 32708, US |
| Mail Address: | 1095 BELLE AVE., CASSELBERRY, FL, 32708, US |
| ZIP code: | 32708 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225338502 | 2010-11-02 | 2022-07-21 | 1095 BELLE AVE, CASSELBERRY, FL, 327082961, US | 1095 BELLE AVE, CASSELBERRY, FL, 327082961, US | |||||||||||||||||||||||||||||||
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| Phone | +1 407-699-4419 |
| Fax | 4076997967 |
Authorized person
| Name | MR. WILLIAM HARRY POE |
| Role | EXECUTIVE DIRECTOR |
| Phone | 4076994419 |
Taxonomy
| Taxonomy Code | 251C00000X - Developmentally Disabled Services Day Training Agency |
| License Number | 002 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MED WAIVER PROVIDER |
| Number | 024209898 |
| State | FL |
| Issuer | FLORIDA MED WAIVER PROVIDER |
| Number | 024209896 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SEMINOLE WORK OPPORTUNITY PROGRAM 403(B) PLAN | 2013 | 591897707 | 2016-02-23 | KATHLEEN ANDERSON COMPREHENSIVE WORK CENTER INC | 9 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2016-02-23 |
| Name of individual signing | SISSY THOMAS |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| RYAN STEPHANIE J | Agent | 1095 BELLE AVENUE, CASSELBERRY, FL, 32708 |
| Name | Role | Address |
|---|---|---|
| Hughes Sandy | Treasurer | 1095 BELLE AVE., CASSELBERRY, FL, 32708 |
| Name | Role | Address |
|---|---|---|
| Dimperio Paula | Vice President | 1095 Belle Ave., Casselberry, FL, 32708 |
| Name | Role | Address |
|---|---|---|
| Eslinger Elise | Member | 1095 Belle Ave., Casselberry, FL, 32708 |
| Neal Kevin | Member | 1095 Belle Ave., Casselberry, FL, 32708 |
| Name | Role | Address |
|---|---|---|
| Ryan Stephanie | Director | 1095 Belle Ave., Casselberry, FL, 32708 |
| Name | Role | Address |
|---|---|---|
| Garcia Lou | President | 1095 Belle Ave, Casselberry, FL, 32708 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000112510 | INSPIRED LIVING | ACTIVE | 2019-10-16 | 2029-12-31 | No data | 1095 BELLE AVENUE, CASSELBERRY, FL, 32708 |
| G17000136836 | INSPIRE YOUR DAY CAFE' | ACTIVE | 2017-12-14 | 2027-12-31 | No data | INSPIRE OF CENTRAL FLORIDA, 1095 BELLE AVENUE, CASSELBERRY, FL, 32708 |
| G16000042432 | INSPIRE OF CENTRAL FLORIDA | ACTIVE | 2016-04-28 | 2027-12-31 | No data | 1095 BELLE AVENUE, 4663016, FL, 32708 |
| G14000016787 | SEMINOLE WORK OPPORTUNITY PROGRAM (SWOP) | EXPIRED | 2014-02-17 | 2019-12-31 | No data | 1095 BELLE AVENUE, CASSELBERRY, FL, 32708 |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J13000539644 | TERMINATED | 1000000459862 | SEMINOLE | 2013-02-11 | 2023-03-06 | $ 811.01 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MAITLAND SERVICE CENTER, 2301 MAITLAND CENTER PKWY STE 160, MAITLAND FL327514192 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
