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  5. THE BOUGAINVILLA HOUSE, INC.

THE BOUGAINVILLA HOUSE, INC. - Florida Company Profile

Company Details

Entity Name: THE BOUGAINVILLA HOUSE, 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: 14 Jul 1981 (44 years ago)
Last Event: AMENDED AND RESTATED ARTICLES
Event Date Filed: 01 Feb 2013 (12 years ago)
Document Number: 759182
FEI/EIN Number 592120945

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 1721 S.E. 4TH AVENUE, FORT LAUDERDALE, FL, 33316
Mail Address: 1721 S.E. 4TH AVENUE, FORT LAUDERDALE, FL, 33316
ZIP code: 33316
County: Broward
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1700243300 2016-01-27 2016-01-27 1721 SE 4TH AVE, FORT LAUDERDALE, FL, 333162515, US 1727 SE 4TH AVE, FORT LAUDERDALE, FL, 333162515, US

Contacts
Phone +1 954-764-7337
Fax 9547646283

Authorized person
Name KELI KORNMILLER
Role SENIOR CREDENTIALING SPECIALIST
Phone 5616728345

Taxonomy
Taxonomy Code 261QR0405X - Substance Use Disorder Rehabilitation Clinic/Center
Is Primary No
Taxonomy Code 261QR0800X - Recovery Care Clinic/Center
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BOUGAINVILLA HOUSE INC 401(K) PROFIT SHARING PLAN & TRUST 2021 592120945 2022-03-31 BOUGAINVILLA HOUSE INC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621420
Sponsor’s telephone number 9547647337
Plan sponsor’s address 1721 SE 4TH AVE, FORT LAUDERDALE, FL, 33316

Signature of
Role Plan administrator
Date 2022-03-31
Name of individual signing CICI KELLY
Valid signature Filed with authorized/valid electronic signature
BOUGAINVILLA HOUSE INC 401(K) PROFIT SHARING PLAN & TRUST 2020 592120945 2021-04-01 BOUGAINVILLA HOUSE INC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621420
Sponsor’s telephone number 9547647337
Plan sponsor’s address 1721 SE 4TH AVE, FORT LAUDERDALE, FL, 33316

Signature of
Role Plan administrator
Date 2021-04-01
Name of individual signing CICI KELLY
Valid signature Filed with authorized/valid electronic signature
BOUGAINVILLA HOUSE INC 401(K) PROFIT SHARING PLAN & TRUST 2019 592120945 2020-04-09 BOUGAINVILLA HOUSE INC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621420
Sponsor’s telephone number 9547647337
Plan sponsor’s address 1721 SE 4TH AVE, FORT LAUDERDALE, FL, 33316

Signature of
Role Plan administrator
Date 2020-04-09
Name of individual signing CICI KELLY
Valid signature Filed with authorized/valid electronic signature
BOUGAINVILLA HOUSE INC 401 K PROFIT SHARING PLAN TRUST 2018 592120945 2019-05-08 BOUGAINVILLA HOUSE INC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621420
Sponsor’s telephone number 9547647337
Plan sponsor’s address 1721 SE 4TH AVE, FORT LAUDERDALE, FL, 33316

Signature of
Role Plan administrator
Date 2019-05-08
Name of individual signing CICI KELLY
Valid signature Filed with authorized/valid electronic signature
BOUGAINVILLA HOUSE INC 401 K PROFIT SHARING PLAN TRUST 2017 592120945 2018-03-20 BOUGAINVILLA HOUSE INC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621420
Sponsor’s telephone number 9547647337
Plan sponsor’s address 1721 SE 4TH AVE, FORT LAUDERDALE, FL, 33316

Signature of
Role Plan administrator
Date 2018-03-20
Name of individual signing CICI KELLY
Valid signature Filed with authorized/valid electronic signature
BOUGAINVILLA HOUSE INC 401 K PROFIT SHARING PLAN TRUST 2016 592120945 2017-05-15 BOUGAINVILLA HOUSE INC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621420
Sponsor’s telephone number 9547647337
Plan sponsor’s address 1721 SE 4TH AVE, FORT LAUDERDALE, FL, 33316

Signature of
Role Plan administrator
Date 2017-05-15
Name of individual signing CICI KELLY
Valid signature Filed with authorized/valid electronic signature
BOUGAINVILLA HOUSE INC 401 K PROFIT SHARING PLAN TRUST 2015 592120945 2016-07-08 BOUGAINVILLA HOUSE INC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621420
Sponsor’s telephone number 9547647337
Plan sponsor’s address 1721 SE 4TH AVE, FORT LAUDERDALE, FL, 33316

Signature of
Role Plan administrator
Date 2016-07-08
Name of individual signing KENNETH BENSON
Valid signature Filed with authorized/valid electronic signature
BOUGAINVILLA HOUSE INC 401 K PROFIT SHARING PLAN TRUST 2014 592120945 2015-05-07 BOUGAINVILLA HOUSE INC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621420
Sponsor’s telephone number 9547647337
Plan sponsor’s address 1721 SE 4TH AVE, FORT LAUDERDALE, FL, 33316

Signature of
Role Plan administrator
Date 2015-05-07
Name of individual signing KACEY BENSON
Valid signature Filed with authorized/valid electronic signature
BOUGAINVILLA HOUSE INC 401 K PROFIT SHARING PLAN TRUST 2013 592120945 2014-06-20 BOUGAINVILLA HOUSE INC 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621420
Sponsor’s telephone number 9547647337
Plan sponsor’s address 1721 SE 4TH AVE, FORT LAUDERDALE, FL, 33316

Signature of
Role Plan administrator
Date 2014-06-20
Name of individual signing KACEY BENSON
Valid signature Filed with authorized/valid electronic signature
HOSPICECARE OF SOUTHEAST FLORIDA, INC GROUP BENEFIT PLAN 2011 592120945 2012-10-31 THE BOUGAINVILLA HOUSE, INC. 191
File View Page
Three-digit plan number (PN) 502
Effective date of plan 1999-04-01
Business code 621610
Sponsor’s telephone number 9544677423
Plan sponsor’s mailing address 321 SE 18TH STREET, FORT LAUDERDALE, FL, 333162817
Plan sponsor’s address 321 SE 18TH STREET, FORT LAUDERDALE, FL, 333162817

Plan administrator’s name and address
Administrator’s EIN 592120945
Plan administrator’s name THE BOUGAINVILLA HOUSE, INC.
Plan administrator’s address 321 SE 18TH STREET, FORT LAUDERDALE, FL, 333162817

Number of participants as of the end of the plan year
Active participants 0

Signature of
Role Plan administrator
Date 2012-10-13
Name of individual signing JANET DAVIS
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
Balzora Lulrick Chairman 1721 SE 4th Avenue, Fort Lauderdale, FL, 33316
Bush Mike Treasurer 1721 S.E. 4TH AVENUE, FORT LAUDERDALE, FL, 33316
Herrlinger Maria Teresa Director 1721 S.E. 4TH AVENUE, FORT LAUDERDALE, FL, 33316
Felix Keny Director 1721 S.E. 4TH AVENUE, FORT LAUDERDALE, FL, 33316
Yates Christine Director 1721 S.E. 4TH AVENUE, FORT LAUDERDALE, FL, 33316
Cartagena Veronica President 1721 SE 4th Avenue, Fort Lauderdale, FL, 33316
Cartagena Veronica Agent 1721 SE 4th Avenue, Ft. Lauderdale, FL, 33316

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G15000111501 HOSPICE CARE OF SOUTHEAST FLORIDA ACTIVE 2015-11-02 2025-12-31 - 1721 SE 4 AVE, FT. LAUDERDALE, FL, 33316
G09000185442 TILLI KIDS EXPIRED 2009-12-16 2014-12-31 - 309 SE 18 STREET, FORT LAUDERDALE, FL, 33316

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2024-01-17 Cartagena, Veronica -
REGISTERED AGENT ADDRESS CHANGED 2019-02-15 1721 SE 4th Avenue, Ft. Lauderdale, FL 33316 -
AMENDED AND RESTATEDARTICLES 2013-02-01 - -
CHANGE OF MAILING ADDRESS 2012-10-03 1721 S.E. 4TH AVENUE, FORT LAUDERDALE, FL 33316 -
REINSTATEMENT 2012-10-03 - -
CHANGE OF PRINCIPAL ADDRESS 2012-10-03 1721 S.E. 4TH AVENUE, FORT LAUDERDALE, FL 33316 -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2012-09-28 - -
NAME CHANGE AMENDMENT 2011-10-25 THE BOUGAINVILLA HOUSE, INC. -
AMENDMENT 2010-11-16 - -
NAME CHANGE AMENDMENT 2001-02-08 HOSPICECARE OF SOUTHEAST FLORIDA, INC. -

Debts

Document Number Status Case Number Name of Court Date of Entry Expiration Date Amount Due Plaintiff
J13001071761 TERMINATED 1000000512363 BROWARD 2013-05-31 2023-06-07 $ 26,006.70 STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3301 N UNIVERSITY DR STE 200, CORAL SPRINGS FL330654149
J13000896952 TERMINATED 1000000428405 BROWARD 2013-05-06 2023-05-08 $ 26,667.05 STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3301 N UNIVERSITY DR STE 200, CORAL SPRINGS FL330654149
J13000744087 TERMINATED 1000000443928 BROWARD 2013-04-11 2023-04-17 $ 42,914.83 STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3301 N UNIVERSITY DR STE 200, CORAL SPRINGS FL330654149

Documents

Name Date
AMENDED ANNUAL REPORT 2024-01-17
ANNUAL REPORT 2024-01-11
AMENDED ANNUAL REPORT 2023-06-27
AMENDED ANNUAL REPORT 2023-03-29
ANNUAL REPORT 2023-03-21
AMENDED ANNUAL REPORT 2022-11-07
ANNUAL REPORT 2022-03-04
AMENDED ANNUAL REPORT 2021-06-16
ANNUAL REPORT 2021-03-12
AMENDED ANNUAL REPORT 2020-11-03

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
59-2120945 Corporation Unconditional Exemption 1721 SE 4TH AVE, FT LAUDERDALE, FL, 33316-2515 1982-01
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, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, 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 Private non-operating foundation
Tax Period 2023-06
Asset 5,000,000 to 9,999,999
Income 1,000,000 to 4,999,999
Filing Requirement 990 - Not required to file (all other)
PF Filing Requirement 990-PF return
Accounting Period Jun
Asset Amount 7723375
Income Amount 1156992
Form 990 Revenue Amount -
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 private foundation. Deductibility Limitation: 30% (generally)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name BOUGAINVILLA HOUSE INC
EIN 59-2120945
Tax Period 202206
Filing Type E
Return Type 990PF
File View File
Organization Name BOUGAINVILLA HOUSE INC
EIN 59-2120945
Tax Period 202106
Filing Type E
Return Type 990PF
File View File
Organization Name BOUGAINVILLA HOUSE INC
EIN 59-2120945
Tax Period 201906
Filing Type E
Return Type 990PF
File View File
Organization Name BOUGAINVILLA HOUSE INC
EIN 59-2120945
Tax Period 201806
Filing Type P
Return Type 990PF
File View File
Organization Name BOUGAINVILLA HOUSE INC
EIN 59-2120945
Tax Period 201706
Filing Type E
Return Type 990
File View File
Organization Name BOUGAINVILLA HOUSE INC
EIN 59-2120945
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
2322937309 2020-04-29 0455 PPP 1721 SE 4TH AVENUE, FORT LAUDERDALE, FL, 33316
Loan Status Date 2021-04-13
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 96360.02
Loan Approval Amount (current) 96360.02
Undisbursed Amount 0
Franchise Name -
Lender Location ID 4392
Servicing Lender Name Centennial Bank
Servicing Lender Address 620 Chestnut St, CONWAY, AR, 72032-5404
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address FORT LAUDERDALE, BROWARD, FL, 33316-0001
Project Congressional District FL-23
Number of Employees 6
NAICS code 621420
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 4392
Originating Lender Name Centennial Bank
Originating Lender Address CONWAY, AR
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 97191.62
Forgiveness Paid Date 2021-03-17

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Companies related by address

No other companies in our directory share the same address as THE BOUGAINVILLA HOUSE, INC.

Date of last update: 01 Apr 2025

Sources: Florida Department of State

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