| Entity Name: | COASTAL TREATMENT CENTER, CLEARWATER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 21 May 2018 (7 years ago) |
| Document Number: | L18000127319 |
| FEI/EIN Number | 83-0644779 |
| Address: | 2120 RANGE ROAD, CLEARWATER, FL, 33765 |
| Mail Address: | 28059 US Hwy 19, Clearwater, FL, 33761, US |
| ZIP code: | 33765 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992284285 | 2018-08-08 | 2019-06-13 | 2120 RANGE RD, CLEARWATER, FL, 337652125, US | 2120 RANGE RD, CLEARWATER, FL, 33765, US | |||||||||||||||||
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| Phone | +1 727-205-7077 |
Authorized person
| Name | CHRISTOPHER WRIGHT FOX |
| Role | PRESIDENT |
| Phone | 3105477501 |
Taxonomy
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 320800000X - Mental Illness Community Based Residential Treatment Facility |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THE WAVE INTERNATIONAL 401(K) PLAN | 2020 | 830644779 | 2021-10-15 | COASTAL TREATMENT CENTER, CLEARWATER | 7 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2021-10-15 |
| Name of individual signing | ASHLEE BRYANT |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| FOX CHRIS | Agent | 2120 RANGE ROAD, CLEARWATER, FL, 33765 |
| Name | Role | Address |
|---|---|---|
| Chris Fox | Auth | 28059 US Hwy 19, Clearwater, FL, 33761 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000087128 | THE WAVE OF CLEARWATER | EXPIRED | 2018-08-01 | 2023-12-31 | No data | 2120 RANGE ROAD, CLEARWATER, FL, 33765 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2021-03-11 | 2120 RANGE ROAD, CLEARWATER, FL 33765 | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-05-21 |
| ANNUAL REPORT | 2024-04-23 |
| ANNUAL REPORT | 2023-03-28 |
| ANNUAL REPORT | 2022-03-11 |
| ANNUAL REPORT | 2021-03-11 |
| ANNUAL REPORT | 2020-01-24 |
| ANNUAL REPORT | 2019-04-30 |
| Florida Limited Liability | 2018-05-21 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
