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  5. THE BREVARD HEALTH ALLIANCE, INC.

THE BREVARD HEALTH ALLIANCE, INC. - Florida Company Profile

Company Details

Entity Name: THE BREVARD HEALTH ALLIANCE, 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: 01 Apr 2003 (22 years ago)
Document Number: N03000002784
FEI/EIN Number 900068515

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 4315 Woodland Park Drive, West Melbourne, FL, 32904, US
Mail Address: 4315 Woodland Park Drive, West Melbourne, FL, 32904, US
ZIP code: 32904
County: Brevard
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1194589341 2024-02-08 2024-04-04 PO BOX 1137, MELBOURNE, FL, 329021137, US 1315 VALENTINE ST, MELBOURNE, FL, 329013127, US

Contacts
Phone +1 321-952-9696
Fax 3219527937
Phone +1 321-241-6800
Fax 3212416890

Authorized person
Name ANGELA CRAIG
Role DIRECTOR OF BILLING
Phone 3216983446

Taxonomy
Taxonomy Code 3336C0003X - Community/Retail Pharmacy
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
THE BREVARD HEALTH ALLIANCE, INC. 401(K) PROFIT S ARING PLAN 2011 900068515 2012-07-02 THE BREVARD HEALTH ALLIANCE, INC. 105
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621399
Sponsor’s telephone number 3217225910
Plan sponsor’s address 3661 S. BABCOCK ST., MELBOURNE, FL, 32901

Plan administrator’s name and address
Administrator’s EIN 900068515
Plan administrator’s name THE BREVARD HEALTH ALLIANCE, INC.
Plan administrator’s address 3661 S. BABCOCK ST., MELBOURNE, FL, 32901
Administrator’s telephone number 3217225910

Signature of
Role Plan administrator
Date 2012-07-02
Name of individual signing LISA GURRI
Valid signature Filed with authorized/valid electronic signature
THE BREVARD HEALTH ALLIANCE, INC. 401(K) PROFIT S ARING PLAN 2010 900068515 2011-06-27 THE BREVARD HEALTH ALLIANCE, INC. 83
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621399
Sponsor’s telephone number 3217225910
Plan sponsor’s address 3661 S. BABCOCK ST., MELBOURNE, FL, 32901

Plan administrator’s name and address
Administrator’s EIN 900068515
Plan administrator’s name THE BREVARD HEALTH ALLIANCE, INC.
Plan administrator’s address 3661 S. BABCOCK ST., MELBOURNE, FL, 32901
Administrator’s telephone number 3217225910

Signature of
Role Plan administrator
Date 2011-06-27
Name of individual signing LISA GURRI
Valid signature Filed with authorized/valid electronic signature
THE BREVARD HEALTH ALLIANCE, INC. 401(K) PROFIT S ARING PLAN 2009 900068515 2010-07-27 THE BREVARD HEALTH ALLIANCE, INC. 59
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621498
Sponsor’s telephone number 3217225910
Plan sponsor’s address 3661 S. BABCOCK ST., MELBOURNE, FL, 32901

Plan administrator’s name and address
Administrator’s EIN 900068515
Plan administrator’s name THE BREVARD HEALTH ALLIANCE, INC.
Plan administrator’s address 3661 S. BABCOCK ST., MELBOURNE, FL, 32901
Administrator’s telephone number 3217225910

Signature of
Role Plan administrator
Date 2010-07-27
Name of individual signing LISA GURRI
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
SHEA ERIN Vice President 4315 WOODLAND PARK DRIVE, WEST MELBOURNE, FL, 32904
Helton Richard A Chief Executive Officer 4315 Woodland Park Drive, West Melbourne, FL, 32904
Anderson Maegen Chief Operating Officer 2120 Sarno Road, MELBOURNE, FL, 32935
ESROCK BRETT HEAL 4315 WOODLAND PARK DRIVE, WEST MELBOURNE, FL, 32904
DONALD KEITH PUBL 4315 WOODLAND PARK DRIVE, WEST MELBOURNE, FL, 32904
SANTIAGO ROBERT Chairman 4315 WOODLAND PARK DRIVE, WEST MELBOURNE, FL, 32904
Johnson Marcus Agent 4315 Woodland Park Drive, West Melbourne, FL, 32904

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2024-04-15 Johnson, Marcus -
CHANGE OF PRINCIPAL ADDRESS 2020-01-15 4315 Woodland Park Drive, West Melbourne, FL 32904 -
CHANGE OF MAILING ADDRESS 2020-01-15 4315 Woodland Park Drive, West Melbourne, FL 32904 -
REGISTERED AGENT ADDRESS CHANGED 2020-01-15 4315 Woodland Park Drive, West Melbourne, FL 32904 -

Documents

Name Date
AMENDED ANNUAL REPORT 2024-04-15
AMENDED ANNUAL REPORT 2024-02-15
ANNUAL REPORT 2024-01-29
ANNUAL REPORT 2023-03-01
ANNUAL REPORT 2022-02-04
ANNUAL REPORT 2021-02-17
ANNUAL REPORT 2020-01-15
ANNUAL REPORT 2019-01-30
ANNUAL REPORT 2018-01-30
ANNUAL REPORT 2017-01-05

USAspending Awards. Financial Assistance

FAIN Awarding Agency Assistance Listings Start Date End Date Description
C81CS14062 Department of Health and Human Services 93.703 - ARRA – GRANTS TO HEALTH CENTER PROGRAMS 2009-06-29 2011-06-28 ARRA - CAPITAL IMPROVEMENT PROGRAM
Recipient THE BREVARD HEALTH ALLIANCE, INC.
Recipient Name Raw BREVARD HEALTH ALLIANCE, INC.
Recipient UEI CT9WXMR4VLN1
Recipient DUNS 139399856
Recipient Address 5270 BABCOCK ST, STE #1, PALM BAY, BREVARD, FLORIDA, 32905-4616, UNITED STATES
Obligated Amount 538610.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
H8BCS12461 Department of Health and Human Services 93.703 - ARRA – GRANTS TO HEALTH CENTER PROGRAMS 2009-03-27 2011-03-26 ARRA - INCREASE SERVICES TO HEALTH CENTERS
Recipient THE BREVARD HEALTH ALLIANCE, INC.
Recipient Name Raw BREVARD HEALTH ALLIANCE, INC.
Recipient UEI CT9WXMR4VLN1
Recipient DUNS 139399856
Recipient Address 5270 BABCOCK ST, STE #1, PALM BAY, BREVARD, FLORIDA, 32905-4616, UNITED STATES
Obligated Amount 275477.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
H80CS04213 Department of Health and Human Services 93.224 - CONSOLIDATED HEALTH CENTERS (COMMUNITY HEALTH CENTERS, MIGRANT HEALTH CENTERS, HEALTH CARE FOR THE HOMELESS, PUBLIC HOUSING PRIMARY CARE, AND SCHOOL BASED HEALTH CENTERS) 2004-12-01 2012-11-30 HEALTH CENTER CLUSTER
Recipient THE BREVARD HEALTH ALLIANCE, INC.
Recipient Name Raw BREVARD HEALTH ALLIANCE, INC.
Recipient UEI CT9WXMR4VLN1
Recipient DUNS 139399856
Recipient Address 5270 BABCOCK ST, STE #1, PALM BAY, BREVARD, FLORIDA, 32905
Obligated Amount 30396468.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
90-0068515 Corporation Unconditional Exemption 4315 WOODLAND PARK DRIVE, WEST MELBOURNE, FL, 32904-2097 2004-07
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 Central - This code is used if the organization is a central type organization (no group exemption) of 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 Hospital or medical research organization 170(b)(1)(A)(iii)
Tax Period 2024-09
Asset 50,000,000 to greater
Income 50,000,000 to greater
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Sep
Asset Amount 59364584
Income Amount 67509743
Form 990 Revenue Amount 67287236
National Taxonomy of Exempt Entities Health Care: Health Treatment Facilities, Primarily Outpatient
Sort Name GULBRETH G THOMAS

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 public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name BREVARD HEALTH ALLIANCE INC
EIN 90-0068515
Tax Period 202309
Filing Type E
Return Type 990
File View File
Organization Name BREVARD HEALTH ALLIANCE INC
EIN 90-0068515
Tax Period 202209
Filing Type E
Return Type 990
File View File
Organization Name BREVARD HEALTH ALLIANCE INC
EIN 90-0068515
Tax Period 202009
Filing Type E
Return Type 990
File View File
Organization Name BREVARD HEALTH ALLIANCE INC
EIN 90-0068515
Tax Period 201909
Filing Type E
Return Type 990
File View File
Organization Name BREVARD HEALTH ALLIANCE INC
EIN 90-0068515
Tax Period 201809
Filing Type E
Return Type 990
File View File
Organization Name BREVARD HEALTH ALLIANCE INC
EIN 90-0068515
Tax Period 201709
Filing Type E
Return Type 990
File View File
Organization Name BREVARD HEALTH ALLIANCE INC
EIN 90-0068515
Tax Period 201609
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
3830777201 2020-04-27 0455 PPP 4315 Woodland Park Drive, Ste 101, Melbourne, FL, 32904
Loan Status Date 2021-02-18
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 4693495
Loan Approval Amount (current) 4693495
Undisbursed Amount 0
Franchise Name -
Lender Location ID 17616
Servicing Lender Name Seacoast National Bank
Servicing Lender Address 815 Colorado Ave, STUART, FL, 34994-3053
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Melbourne, BREVARD, FL, 32904-1000
Project Congressional District FL-08
Number of Employees 336
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 124402
Originating Lender Name Seacoast National Bank
Originating Lender Address Melbourne, FL
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 4728565.84
Forgiveness Paid Date 2021-01-26

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Companies related by address

No other companies in our directory share the same address as THE BREVARD HEALTH ALLIANCE, INC.

Date of last update: 02 Apr 2025

Sources: Florida Department of State

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