| Entity Name: | CROSSROADS BEHAVIORAL HEALTH CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 07 Feb 2005 (20 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 07 Nov 2022 (2 years ago) |
| Document Number: | N05000001495 |
| FEI/EIN Number | 203526333 |
| Address: | 708 Goodlette-Frank Rd N, Naples, FL, 34102, US |
| Mail Address: | 708 Goodlette-Frank Rd N, Naples, FL, 34102, US |
| ZIP code: | 34102 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285775460 | 2007-02-09 | 2022-07-21 | 3606 ENTERPRISE AVE STE 300, NAPLES, FL, 341043670, US | 3606 ENTERPRISE AVE STE 300, NAPLES, FL, 341043670, US | |||||||||||||||||||||||||||||||||
|
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| Phone | +1 239-692-1020 |
| Fax | 2393307168 |
Authorized person
| Name | GREGORY JOSEPH FINER |
| Role | CEO |
| Phone | 2396921020 |
Taxonomy
| Taxonomy Code | 104100000X - Social Worker |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
| Taxonomy Code | 261QR0405X - Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | 2601 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 767646800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FINER GREGORY J | Agent | 2181 17th St SW, NAPLES, FL, 34117 |
| Name | Role | Address |
|---|---|---|
| FINER GREGORY J | Chief Executive Officer | 2181 17th St SW, Naples, FL, 34117 |
| Name | Role | Address |
|---|---|---|
| GIBSON ROBERT | Chief Financial Officer | 704 Goodlette-Frank Rd, Naples, FL, 34102 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-10-26 | 708 Goodlette-Frank Rd N, STE 351, Naples, FL 34102 | No data |
| CHANGE OF MAILING ADDRESS | 2023-10-26 | 708 Goodlette-Frank Rd N, STE 351, Naples, FL 34102 | No data |
| REINSTATEMENT | 2022-11-07 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| AMENDMENT | 2021-11-01 | No data | No data |
| REINSTATEMENT | 2021-05-13 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| REINSTATEMENT | 2019-10-23 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| REINSTATEMENT | 2017-04-12 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-02 |
| ANNUAL REPORT | 2023-04-13 |
| REINSTATEMENT | 2022-11-07 |
| Off/Dir Resignation | 2022-02-22 |
| Amendment | 2021-11-01 |
| REINSTATEMENT | 2021-05-13 |
| REINSTATEMENT | 2019-10-23 |
| ANNUAL REPORT | 2018-09-06 |
| REINSTATEMENT | 2017-04-12 |
| REINSTATEMENT | 2015-10-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
