| Entity Name: | SAMARITAN COUNSELING CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 16 Jan 1979 (46 years ago) |
| Date of dissolution: | 30 Dec 1998 (26 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 30 Dec 1998 (26 years ago) |
| Document Number: | 745564 |
| FEI/EIN Number |
591869068
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 2430 ESTANCIA BOULEVARD, ST 112, CLEARWATER, FL, 33761, US |
| Mail Address: | 2430 ESTANCIA BLVD, SUITE 112, CLEARWATER, FL, 33757 |
| ZIP code: | 33761 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356877047 | 2017-05-02 | 2017-05-02 | 6760 N PINE ISLAND RD, TAMARAC, FL, 333213715, US | 101 SE 3RD AVENUE, FORT LAUDERDALE, FL, 33301, US | |||||||||||||||||
|
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| Phone | +1 561-401-8527 |
Authorized person
| Name | MR. MALLICA DAVID REYNOLDS |
| Role | CLINICAL DIRECTOR |
| Phone | 5614018527 |
Taxonomy
| Taxonomy Code | 320800000X - Mental Illness Community Based Residential Treatment Facility |
| License Number | MT3178 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HARRIS II M D NORMAN | Vice President | 155 PALMETTO, BELLEAIR, FL, 34616 |
| HARRIS II M D NORMAN | Director | 155 PALMETTO, BELLEAIR, FL, 34616 |
| MATLTBY DIANE | Secretary | 36 COUNTRY CLUB DRIVE, LARGO, FL, 33771 |
| MATLTBY DIANE | Director | 36 COUNTRY CLUB DRIVE, LARGO, FL, 33771 |
| WAGENSEIL ROBERT | President | 1615 FIRST STREET, INDIAN ROCKS BEACH, FL |
| WAGENSEIL ROBERT | Director | 1615 FIRST STREET, INDIAN ROCKS BEACH, FL |
| BRISKMAN JOEL | Treasurer | 66 MIDWAY ISLAND, CLEARWATER, FL, 33767 |
| BRISKMAN JOEL | Director | 66 MIDWAY ISLAND, CLEARWATER, FL, 33767 |
| FIELD DAVID L | Agent | 1215 HUNTINGTON LANE, SAFETY HARBOR, FL, 34695 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 1998-12-30 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 1998-06-18 | 2430 ESTANCIA BOULEVARD, ST 112, CLEARWATER, FL 33761 | - |
| REGISTERED AGENT NAME CHANGED | 1998-06-18 | FIELD, DAVID L | - |
| REGISTERED AGENT ADDRESS CHANGED | 1998-06-18 | 1215 HUNTINGTON LANE, SAFETY HARBOR, FL 34695 | - |
| CHANGE OF MAILING ADDRESS | 1998-06-05 | 2430 ESTANCIA BOULEVARD, ST 112, CLEARWATER, FL 33761 | - |
| AMENDMENT AND NAME CHANGE | 1997-11-24 | SAMARITAN COUNSELING CENTER, INC. | - |
| Name | Date |
|---|---|
| Voluntary Dissolution | 1998-12-30 |
| ANNUAL REPORT | 1998-06-18 |
| Amendment and Name Change | 1997-11-24 |
| ANNUAL REPORT | 1997-05-16 |
| ANNUAL REPORT | 1996-05-21 |
| ANNUAL REPORT | 1995-05-01 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
