| Entity Name: | ATLANTIC PSYCHIATRIC CENTERS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 04 May 1982 (43 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 12 Jan 1998 (27 years ago) |
| Document Number: | F78847 |
| FEI/EIN Number | 59-2192895 |
| Address: | 2123 FRANKLIN DRIVE, PALM BAY, FL 32905 |
| Mail Address: | 2123 FRANKLIN DRIVE, PALM BAY, FL 32905 |
| ZIP code: | 32905 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386691418 | 2006-05-26 | 2023-06-12 | 2123 FRANKLIN DR NE, PALM BAY, FL, 329054022, US | 2123 FRANKLIN DR NE, PALM BAY, FL, 329054022, US | |||||||||||||||||||||||||||||||||||||
|
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| Fax | 3217223590 |
| Phone | +1 321-724-1614 |
Authorized person
| Name | KATHY M CASE |
| Role | OFFICE MANAGER |
| Phone | 3217241614 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| Is Primary | No |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 116755200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FRESE, GARY B | Agent | 930 S HARBOR CITY BLVD, STE 505, MELBOURNE, FL 32901 |
| Name | Role | Address |
|---|---|---|
| Cohen, Robert E., M.D. | President | 2123 FRANKLIN DRIVE, PALM BAY, FL 32905 |
| Name | Role | Address |
|---|---|---|
| Jacobson, James N., M.D. | Vice President | 2123 FRANKLIN DRIVE, PALM BAY, FL 32905 |
| Name | Role | Address |
|---|---|---|
| Brown, Jordan, M.D. | Secretary | 2123 Franklin Drive, N.E., PALM BAY, FL 32905 |
| Name | Role | Address |
|---|---|---|
| Brown, Jordan, M.D. | Treasurer | 2123 Franklin Drive, N.E., PALM BAY, FL 32905 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2001-05-11 | 2123 FRANKLIN DRIVE, PALM BAY, FL 32905 | No data |
| CHANGE OF MAILING ADDRESS | 2001-05-11 | 2123 FRANKLIN DRIVE, PALM BAY, FL 32905 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 1999-04-29 | 930 S HARBOR CITY BLVD, STE 505, MELBOURNE, FL 32901 | No data |
| REGISTERED AGENT NAME CHANGED | 1999-04-29 | FRESE, GARY B | No data |
| REINSTATEMENT | 1998-01-12 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1997-09-26 | No data | No data |
| NAME CHANGE AMENDMENT | 1992-09-23 | ATLANTIC PSYCHIATRIC CENTERS, INC. | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J15000584579 | LAPSED | 05-2014-CA-046950 | BREVARD COUNTY CIRCUIT COURT | 2015-05-19 | 2020-05-21 | $130,789.42 | WENDY MOSELEY, PERSONAL REPRESENTATIVE, 1173 VESTAVIA CIRCLE, MELBOURNE, FL 32940 |
| J15000580908 | LAPSED | 05-2014-CA-046950 | BREVARD COUNTY CIRCUIT COURT | 2015-05-15 | 2020-05-18 | $88,715.50 | WENDY MOSELEY, PERSONAL REPRESENTATIVE, 1173 VESTAVIA CIRCLE, MELBOURNE, FL 32940 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-19 |
| ANNUAL REPORT | 2023-02-13 |
| ANNUAL REPORT | 2022-03-28 |
| AMENDED ANNUAL REPORT | 2021-08-16 |
| ANNUAL REPORT | 2021-03-16 |
| ANNUAL REPORT | 2020-04-16 |
| ANNUAL REPORT | 2019-04-15 |
| ANNUAL REPORT | 2018-04-02 |
| ANNUAL REPORT | 2017-01-19 |
| ANNUAL REPORT | 2016-03-21 |
Date of last update: 05 Feb 2025
Sources: Florida Department of State
