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HAZELDEN BETTY FORD FOUNDATION CORPORATION - Florida Company Profile

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Company Details

Entity Name: HAZELDEN BETTY FORD FOUNDATION CORPORATION
Jurisdiction: FLORIDA
Filing Type: Foreign 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: 29 Dec 2004 (21 years ago)
Branch of: HAZELDEN BETTY FORD FOUNDATION CORPORATION, MINNESOTA (Company Number 86675c57-b7d4-e011-a886-001ec94ffe7f)
Last Event: NAME CHANGE AMENDMENT
Event Date Filed: 05 May 2014 (11 years ago)
Document Number: F04000007300
FEI/EIN Number 41-0682405

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 15251 Pleasant Valley Road, Center City, MN, 55012, US
Mail Address: 15251 Pleasant Valley Road, Center City, MN, 55012, US
Place of Formation: MINNESOTA

Key Officers & Management

Name Role Address
Bales Susan F Director 15251 Pleasant Valley Road, Center City, MN, 55012
Barker Ruth Director 15251 Pleasant Valley Road, Center City, MN, 55012
Greenbaum James R Director 15251 Pleasant Valley Road, Center City, MN, 55012
Parker Bill Director 15251 Pleasant Valley Road, Center City, MN, 55012
Power John Sr. Director 15251 Pleasant Valley Road, Center City, MN, 55012
Robb Cini F Director 15251 Pleasant Valley Road, Center City, MN, 55012
C T CORPORATION SYSTEM Agent -

National Provider Identifier

NPI Number:
1386972719
Certification Date:
2025-05-16

Authorized Person:

Name:
ASHLEY GIBSON
Role:
VP PAYER RELATIONS
Phone:

Taxonomy:

Selected Taxonomy:
261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center)
Is Primary:
No
Selected Taxonomy:
261QR0405X - Substance Use Disorder Rehabilitation Clinic/Center
Is Primary:
No
Selected Taxonomy:
324500000X - Substance Abuse Rehabilitation Facility
Is Primary:
Yes

Contacts:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G16000025293 HAZELDEN NAPLES ACTIVE 2016-03-09 2026-12-31 - HAZELDEN BETTY FORD FOUNDATION, 15251 PLEASANT VALLEY ROAD, MAILSTOP BC8, CENTER CITY, MN, 55012
G14000043527 HAZELDEN FLORIDA ACTIVE 2014-05-02 2029-12-31 - 15251 PLEASANT VALLEY RD, CENTER CITY, MN, 55012
G10000029390 HAZEL'S CUP EXPIRED 2010-04-01 2015-12-31 - 950 SIXTH AVENUE NORTH, NAPLES, FL, 34102
G09000164531 HAZELDEN FLORIDA EXPIRED 2009-10-13 2014-12-31 - 15251 PLEASANT VALLEY RD., CENTER CITY, MN, 55012

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-04-13 15251 Pleasant Valley Road, Center City, MN 55012 -
CHANGE OF MAILING ADDRESS 2024-04-13 15251 Pleasant Valley Road, Center City, MN 55012 -
NAME CHANGE AMENDMENT 2014-05-05 HAZELDEN BETTY FORD FOUNDATION CORPORATION -

Documents

Name Date
ANNUAL REPORT 2024-04-13
ANNUAL REPORT 2023-03-01
ANNUAL REPORT 2022-03-28
ANNUAL REPORT 2021-04-23
ANNUAL REPORT 2020-05-30
AMENDED ANNUAL REPORT 2019-04-02
ANNUAL REPORT 2019-03-18
ANNUAL REPORT 2018-04-06
ANNUAL REPORT 2017-04-13
ANNUAL REPORT 2016-04-22

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Date of last update: 01 Jul 2025

Sources: Florida Department of State