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NEW HORIZONS COMMUNITY MENTAL HEALTH CENTER, INC

Company Details

Entity Name: NEW HORIZONS COMMUNITY MENTAL HEALTH CENTER, INC
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active
Date Filed: 03 Feb 1981 (44 years ago)
Document Number: 756184
FEI/EIN Number 592055751
Address: 1469 NW 36TH STREET, MIAMI, FL, 33142, US
Mail Address: 1469 NW 36TH STREET, MIAMI, FL, 33142, US
ZIP code: 33142
County: Miami-Dade
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1306483441 2019-12-09 2019-12-09 1469 NW 36TH ST, MIAMI, FL, 331425557, US 1469 NW 36TH ST, MIAMI, FL, 331425557, US

Contacts

Phone +1 305-635-7444

Authorized person

Name DR. EVALINA WILLIAMS BESTMAN
Role CEO
Phone 3056350366

Taxonomy

Taxonomy Code 261QC1500X - Community Health Clinic/Center
Is Primary Yes
Taxonomy Code 261QF0050X - Non-Surgical Family Planning Clinic/Center
Is Primary No
Taxonomy Code 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center)
Is Primary No
Taxonomy Code 291U00000X - Clinical Medical Laboratory
Is Primary No
Taxonomy Code 3336C0003X - Community/Retail Pharmacy
Is Primary No

Other Provider Identifiers

Issuer MEDICAID
Number 0603465
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
403(B) THRIFT PLAN OF NEW HORIZONS COMMUNITY MENTAL HEALTH CENTER 2023 592055751 2024-09-18 NEW HORIZONS COMMUNITY MENTAL HEALTH CENTER 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621420
Sponsor’s telephone number 3056350366
Plan sponsor’s address 1469 NW 36TH STREET, MIAMI, FL, 33142

Plan administrator’s name and address

Administrator’s EIN 592055751
Plan administrator’s name ULLAS KURIAKOSE
Plan administrator’s address 1469 NW 36TH STREET, MIAMI, FL, 33142
Administrator’s telephone number 3056350366
403(B) THRIFT PLAN OF NEW HORIZONS COMMUNITY MENTAL HEALTH CENTER 2022 592055751 2023-08-15 NEW HORIZONS COMMUNITY MENTAL HEALTH CENTER 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621420
Sponsor’s telephone number 3056350366
Plan sponsor’s address 1469 NW 36TH STREET, MIAMI, FL, 33142

Plan administrator’s name and address

Administrator’s EIN 592055751
Plan administrator’s name ULLAS KURIAKOSE
Plan administrator’s address 1469 NW 36TH STREET, MIAMI, FL, 33142
Administrator’s telephone number 3056350366

Signature of

Role Plan administrator
Date 2023-08-11
Name of individual signing ULLAS KURIAKOSE
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF NEW HORIZONS COMMUNITY MENTAL HEALTH CENTER 2021 592055751 2022-10-11 NEW HORIZONS COMMUNITY MENTAL HEALTH CENTER 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621420
Sponsor’s telephone number 3056350366
Plan sponsor’s address 1469 NW 36TH STREET, MIAMI, FL, 33142

Plan administrator’s name and address

Administrator’s EIN 592055751
Plan administrator’s name ULLAS KURIAKOSE
Plan administrator’s address 1469 NW 36TH STREET, MIAMI, FL, 33142
Administrator’s telephone number 3056350366

Signature of

Role Plan administrator
Date 2022-10-07
Name of individual signing ULLAS KURIAKOSE
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF NEW HORIZONS COMMUNITY MENTAL HEALTH CENTER 2020 592055751 2021-10-06 NEW HORIZONS COMMUNITY MENTAL HEALTH CENTER 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621420
Sponsor’s telephone number 3056350366
Plan sponsor’s address 1469 NW 36TH STREET, MIAMI, FL, 33142

Plan administrator’s name and address

Administrator’s EIN 592055751
Plan administrator’s name ULLAS KURIAKOSE
Plan administrator’s address 1469 NW 36TH STREET, MIAMI, FL, 33142
Administrator’s telephone number 3056350366

Signature of

Role Plan administrator
Date 2021-10-06
Name of individual signing ULLAS KURIAKOSE
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF NEW HORIZONS COMMUNITY MENTAL HEALTH CENTER 2019 592055751 2020-10-02 NEW HORIZONS COMMUNITY MENTAL HEALTH CENTER 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621420
Sponsor’s telephone number 3056350366
Plan sponsor’s address 1469 NW 36TH STREET, MIAMI, FL, 33142

Plan administrator’s name and address

Administrator’s EIN 592055751
Plan administrator’s name EVALINA BESTMAN
Plan administrator’s address 1469 NW 36TH STREET, MIAMI, FL, 33142
Administrator’s telephone number 3056350366

Signature of

Role Plan administrator
Date 2020-10-01
Name of individual signing EVALINA BESTMAN
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF NEW HORIZONS COMMUNITY MENTAL HEALTH CENTER 2018 592055751 2019-10-14 NEW HORIZONS COMMUNITY MENTAL HEALTH CENTER 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621420
Sponsor’s telephone number 3056350366
Plan sponsor’s address 1469 NW 36TH STREET, MIAMI, FL, 33142

Plan administrator’s name and address

Administrator’s EIN 592055751
Plan administrator’s name EVALINA BESTMAN
Plan administrator’s address 1469 NW 36TH STREET, MIAMI, FL, 33142
Administrator’s telephone number 3056350366

Signature of

Role Plan administrator
Date 2019-10-14
Name of individual signing EVALINA BESTMAN
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF NEW HORIZONS COMMUNITY MENTAL HEALTH CENTER 2017 592055751 2018-10-05 NEW HORIZONS COMMUNITY MENTAL HEALTH CENTER 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621420
Sponsor’s telephone number 3056350366
Plan sponsor’s address 1469 NW 36TH STREET, MIAMI, FL, 33142

Plan administrator’s name and address

Administrator’s EIN 592055751
Plan administrator’s name EVALINA BESTMAN
Plan administrator’s address 1469 NW 36TH STREET, MIAMI, FL, 33142
Administrator’s telephone number 3056350366

Signature of

Role Plan administrator
Date 2018-10-04
Name of individual signing EVALINA BESTMAN
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF NEW HORIZONS COMMUNITY MENTAL HEALTH CENTER 2016 592055751 2017-09-29 NEW HORIZONS COMMUNITY MENTAL HEALTH CENTER 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621420
Sponsor’s telephone number 3056350366
Plan sponsor’s address 1469 NW 36TH STREET, MIAMI, FL, 33142

Plan administrator’s name and address

Administrator’s EIN 592055751
Plan administrator’s name EVALINA BESTMAN
Plan administrator’s address 1469 NW 36TH STREET, MIAMI, FL, 33142
Administrator’s telephone number 3056350366

Signature of

Role Plan administrator
Date 2017-09-28
Name of individual signing EVALINA BESTMAN
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF NEW HORIZONS COMMUNITY MENTAL HEALTH CENTER 2015 592055751 2016-10-14 NEW HORIZONS COMMUNITY MENTAL HEALTH CENTER 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621420
Sponsor’s telephone number 3056350366
Plan sponsor’s address 1469 NW 36TH STREET, MIAMI, FL, 33142

Plan administrator’s name and address

Administrator’s EIN 592055751
Plan administrator’s name EVALINA BESTMAN
Plan administrator’s address 1469 NW 36TH ST, MIAMI, FL, 33142

Signature of

Role Plan administrator
Date 2016-10-14
Name of individual signing EVALINA BESTMAN
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF NEW HORIZONS COMMUNITY MENTAL HEALTH CENTER 2014 592055751 2015-10-07 NEW HORIZONS COMMUNITY MENTAL HEALTH CENTER 37
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621420
Sponsor’s telephone number 3056350366
Plan sponsor’s address 1469 NW 36TH STREET, MIAMI, FL, 33142

Signature of

Role Plan administrator
Date 2015-10-07
Name of individual signing EVALINA BESTMAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
RODRIGUEZ GERARDO Agent 1469 NW 36TH STREET, MIAMI, FL, 33142

Chief Executive Officer

Name Role Address
Wyatt-Sweeting Michele Y Chief Executive Officer 1469 NW 36 Street, Miami, FL, 33142

Vice President

Name Role Address
JONES-WILFORK BOBBIE Vice President 1469 NW 36TH STREET, MIAMI, FL, 33142

Director

Name Role Address
BALTAGI LABIB Director 1469 N.W. 36TH ST, MIAMI, FL, 33142
Evans Gloria Director 1469 NW 36TH STREET, MIAMI, FL, 33142
KELLEY WILLIAM M Director 1469 NW 36TH STREET, MIAMI, FL, 33142
JONES-WILFORK BOBBIE Director 1469 NW 36TH STREET, MIAMI, FL, 33142

Secretary

Name Role Address
Evans Gloria Secretary 1469 NW 36TH STREET, MIAMI, FL, 33142

Treasurer

Name Role Address
BALTAGI LABIB Treasurer 1469 N.W. 36TH ST, MIAMI, FL, 33142

President

Name Role Address
KELLEY WILLIAM M President 1469 NW 36TH STREET, MIAMI, FL, 33142

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G20000161051 DR. EVALINA BESTMAN NEWHORIZONS COMMUNITY MENTAL HEALTH CENTER ACTIVE 2020-12-18 2025-12-31 No data 1469 NW 36TH STREET, MIAMI, FL, 33142
G19000129207 HORIZONS INTEGRATED HEALTHCARE EXPIRED 2019-12-06 2024-12-31 No data NEW HORIZONS COMMUNITY MENTAL HEALTH CEN, NEW HORIZONS COMMUNITY MENTAL HEALTH CEN, MIAMI, FL, 33142

Events

Event Type Filed Date Value Description
REINSTATEMENT 1984-12-12 No data No data
INVOLUNTARILY DISSOLVED 1984-11-21 No data No data
REINSTATEMENT 1983-12-23 No data No data
INVOLUNTARILY DISSOLVED 1982-12-14 No data No data
NAME CHANGE AMENDMENT 1981-08-18 NEW HORIZONS COMMUNITY MENTAL HEALTH CENTER, INC No data

Debts

Document Number Status Case Number Name of Court Date of Entry Expiration Date Amount Due Plaintiff
J14000946193 LAPSED 14-13421 CA(01) MIAMI- DADE CIRCUIT COURT 2014-11-21 2019-11-21 $27,454.78 STAR ONE STAFFING INC., C/O 19 WEST FLAGLER STREET, 703, MIAMI, FLORIDA 33130
J14000784370 TERMINATED 14-13421 CA(01) MIAMI- DADE CIRCUIT COURT 2014-07-03 2019-07-10 $42,949.13 STAR ONE STAFFING INC., C/O 19 WEST FLAGLER STREET, 703, MIAMI, FLORIDA 33130
J13001460154 TERMINATED 1000000529323 MIAMI-DADE 2013-09-19 2023-10-03 $ 80,740.77 STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828

Date of last update: 02 Jan 2025

Sources: Florida Department of State