| Entity Name: | FLORIDA COMMUNITY ALLIANCE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Inactive |
| Date Filed: | 17 Dec 2008 (16 years ago) |
| Date of dissolution: | 20 Jun 2016 (9 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 20 Jun 2016 (9 years ago) |
| Document Number: | N08000011386 |
| FEI/EIN Number | 900433146 |
| Address: | 1870 FOREST HILL BLVD., STE 204, WEST PALM BEACH, FL, 33406, US |
| Mail Address: | 1870 FOREST HILL BLVD., STE 204, WEST PALM BEACH, FL, 33406, US |
| ZIP code: | 33406 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1871917054 | 2014-02-10 | 2014-02-10 | 1870 FOREST HILL BLVD, SUITE 200, WEST PALM BEACH, FL, 334068901, US | 1870 FOREST HILL BLVD, SUITE 200, WEST PALM BEACH, FL, 334068901, US | |||||||||||||||||||||||||||||||
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| Phone | +1 561-904-6514 |
Authorized person
| Name | MRS. MINERVA KING |
| Role | EXECUTIVE DIRECTOR |
| Phone | 5619046514 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1063768307 |
| State | FL |
| Issuer | MEDICAID |
| Number | 1912956384 |
| State | FL |
| Issuer | MEDICAID |
| Number | 1336441401 |
| State | FL |
| Name | Role |
|---|---|
| LAW OFFICES OF PAUL J. BURKHART, PL | Agent |
| Name | Role | Address |
|---|---|---|
| KING MINERVA L | Exec | 1870 FOREST HILL BLVD., WEST PALM BEACH, FL, 33406 |
| Name | Role | Address |
|---|---|---|
| Quraeshi Sohail | President | 10664 Acme Rd, Wellington, FL, 33414 |
| Name | Role | Address |
|---|---|---|
| LUCIANO MARK | Chief Financial Officer | 1870 FOREST HILL BLVD., WEST PALM BEACH, FL, 33406 |
| Name | Role | Address |
|---|---|---|
| JIM CUMMINGS D | Secretary | 1870 FOREST HILL BLVD., West Palm Beach, FL, 33406 |
| Name | Role | Address |
|---|---|---|
| LAOS CLAUDIA | Vice President | 1870 FOREST HILL BLVD., WEST PALM BEACH, FL, 33406 |
| Name | Role | Address |
|---|---|---|
| Gaffley Michael L | Boar | Nova Southeastern University, North Miami Beach, FL, 33162 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2016-06-20 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-06-17 | 1870 FOREST HILL BLVD., STE 204, WEST PALM BEACH, FL 33406 | No data |
| CHANGE OF MAILING ADDRESS | 2015-06-17 | 1870 FOREST HILL BLVD., STE 204, WEST PALM BEACH, FL 33406 | No data |
| AMENDMENT | 2009-12-07 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2009-12-07 | LAW OFFICES OF PAUL J. BURKHART, PL | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-12-07 | 800 VILLAGE SQUARE CROSSING, PALM BEACH GARDENS, FL 33410 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2016-06-20 |
| ANNUAL REPORT | 2015-06-17 |
| ANNUAL REPORT | 2014-04-30 |
| ANNUAL REPORT | 2013-04-22 |
| ANNUAL REPORT | 2012-01-05 |
| ANNUAL REPORT | 2011-04-25 |
| ANNUAL REPORT | 2010-01-06 |
| Amendment | 2009-12-07 |
| Off/Dir Resignation | 2009-11-16 |
| ANNUAL REPORT | 2009-09-08 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
