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  5. GENESIS COMMUNITY HEALTH, INC.

GENESIS COMMUNITY HEALTH, INC.

Company Details

Entity Name: GENESIS COMMUNITY HEALTH, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active
Date Filed: 17 Mar 2009 (16 years ago)
Document Number: N09000002682
FEI/EIN Number 800374741
Address: 639 East Ocean Ave, BOYNTON BEACH, FL, 33435, US
Mail Address: 639 E Ocean Ave, Boynton Beach, FL, 33435-5011, US
ZIP code: 33435
County: Palm Beach
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1437930815 2023-10-11 2024-11-04 639 E OCEAN AVE STE 409, BOYNTON BEACH, FL, 334355017, US 2455 W ATLANTIC AVE RM 5-107, DELRAY BEACH, FL, 334454425, US

Contacts
Phone +1 561-806-6835
Phone +1 561-266-0961

Authorized person
Name DEANNA WARREN
Role CEO
Phone 5618066835

Taxonomy
Taxonomy Code 261QF0400X - Federally Qualified Health Center (FQHC)
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 006608619
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
403(B) THRIFT PLAN OF GENESIS COMMUNITY HEALTH, INC. 2023 800374741 2024-10-14 GENESIS COMMUNITY HEALTH, INC. 81
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-04-01
Business code 621112
Sponsor’s telephone number 5612499993
Plan sponsor’s address 639 E OCEAN AVE STE 409, BOYNTON BEACH, FL, 334355017

Signature of
Role Plan administrator
Date 2024-10-14
Name of individual signing JOHN DENOON
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF GENESIS COMMUNITY HEALTH, INC. 2022 800374741 2023-10-16 GENESIS COMMUNITY HEALTH, INC. 56
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-04-01
Business code 621112
Sponsor’s telephone number 5612499993
Plan sponsor’s address 639 E OCEAN AVE STE 409, BOYNTON BEACH, FL, 334355017

Signature of
Role Plan administrator
Date 2023-10-16
Name of individual signing JOHN DENOON
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF GENESIS COMMUNITY HEALTH, INC. 2022 800374741 2023-10-16 GENESIS COMMUNITY HEALTH, INC. 56
Three-digit plan number (PN) 001
Effective date of plan 2011-04-01
Business code 621112
Sponsor’s telephone number 5612499993
Plan sponsor’s address 639 E OCEAN AVE STE 409, BOYNTON BEACH, FL, 334355017

Signature of
Role Plan administrator
Date 2023-10-16
Name of individual signing JOHN DENOON
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF GENESIS COMMUNITY HEALTH, INC. 2021 800374741 2022-10-26 GENESIS COMMUNITY HEALTH, INC. 47
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-04-01
Business code 621112
Sponsor’s telephone number 5612499993
Plan sponsor’s address 639 E OCEAN AVE STE 409, BOYNTON BEACH, FL, 334355017

Signature of
Role Plan administrator
Date 2022-10-26
Name of individual signing JOHN DENOON
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF GENESIS COMMUNITY HEALTH, INC. 2020 800374741 2021-08-17 GENESIS COMMUNITY HEALTH, INC. 52
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-04-01
Business code 621112
Sponsor’s telephone number 5612499993
Plan sponsor’s address 2623 S SEACREST BLVD STE 65, BOYNTON BEACH, FL, 334357541

Signature of
Role Plan administrator
Date 2021-08-17
Name of individual signing JOHN DENOON
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF GENESIS COMMUNITY HEALTH, INC. 2019 800374741 2020-10-08 GENESIS COMMUNITY HEALTH, INC. 51
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-04-01
Business code 621112
Sponsor’s telephone number 5618066835
Plan sponsor’s address 2623 S SEACREST BLVD STE 65, BOYNTON BEACH, FL, 334357541

Signature of
Role Plan administrator
Date 2020-10-08
Name of individual signing JOHN DENOON
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF GENESIS COMMUNITY HEALTH, INC. 2018 800374741 2019-10-11 GENESIS COMMUNITY HEALTH, INC. 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-04-01
Business code 621112
Sponsor’s telephone number 5612499993
Plan sponsor’s address 2623 S SEACREST BLVD STE 65, BOYNTON BEACH, FL, 334357541

Signature of
Role Plan administrator
Date 2019-10-11
Name of individual signing JOHN DENOON
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF GENESIS COMMUNITY HEALTH INC 2017 800374741 2018-10-11 GENESIS COMMUNITY HEALTH INC 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-04-01
Business code 621112
Sponsor’s telephone number 5612499993
Plan sponsor’s address 2623 S SEACREST BLVD STE 65, BOYNTON BEACH, FL, 334357541

Signature of
Role Plan administrator
Date 2018-10-11
Name of individual signing JOHN DENOON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-11
Name of individual signing JOHN DENOON
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF GENESIS COMMUNITY HEALTH, INC. 2016 800374741 2017-07-20 GENESIS COMMUNITY HEALTH, INC. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-04-01
Business code 621112
Sponsor’s telephone number 5617356553
Plan sponsor’s address 2623 SOUTH SEACREST BLVD., SUITE 65, BOYNTON BEACH, FL, 33435

Signature of
Role Plan administrator
Date 2017-07-20
Name of individual signing JOHN DENOON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-20
Name of individual signing JOHN DENOON
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF GENESIS COMMUNITY HEALTH, INC. 2015 800374741 2016-06-30 GENESIS COMMUNITY HEALTH, INC. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-04-01
Business code 621112
Sponsor’s telephone number 5612499993
Plan sponsor’s address 564 E WOOLBRIGHT RD, BOYNTON BEACH, FL, 33435

Signature of
Role Plan administrator
Date 2016-06-30
Name of individual signing JOHN DENOON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-06-30
Name of individual signing JOHN DENOON
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
WARREN DEANNA M Agent 639 East Ocean Ave, BOYNTON BEACH, FL, 33435

Chief Executive Officer

Name Role Address
WARREN DEANNA Chief Executive Officer 639 East Ocean Ave, BOYNTON BEACH, FL, 33435

Chairman

Name Role Address
DeFrancesco David Chairman 639 East Ocean Ave, BOYNTON BEACH, FL, 33435

Vice Chairman

Name Role Address
Schrubb Terry L Vice Chairman 639 East Ocean Ave, BOYNTON BEACH, FL, 33435

Mr

Name Role Address
Papadimitriou George Mr 639 East Ocean Ave, BOYNTON BEACH, FL, 33435
Petty Ricky Mr 639 East Ocean Ave, BOYNTON BEACH, FL, 33435

Mrs

Name Role Address
Bush Kemberly Mrs 639 East Ocean Ave, BOYNTON BEACH, FL, 33435

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2021-01-26 639 East Ocean Ave, Suite 409, BOYNTON BEACH, FL 33435 No data
CHANGE OF MAILING ADDRESS 2021-01-26 639 East Ocean Ave, Suite 409, BOYNTON BEACH, FL 33435 No data
REGISTERED AGENT ADDRESS CHANGED 2021-01-26 639 East Ocean Ave, Suite 409, BOYNTON BEACH, FL 33435 No data
REGISTERED AGENT NAME CHANGED 2012-04-23 WARREN, DEANNA M No data

Documents

Name Date
ANNUAL REPORT 2024-02-05
ANNUAL REPORT 2023-02-07
ANNUAL REPORT 2022-03-10
ANNUAL REPORT 2021-01-26
ANNUAL REPORT 2020-01-31
ANNUAL REPORT 2019-01-27
AMENDED ANNUAL REPORT 2018-05-02
ANNUAL REPORT 2018-02-06
ANNUAL REPORT 2017-05-03
ANNUAL REPORT 2016-03-07

Related by officers

Papadimitriou George

FLORIDA ASSOCIATION OF FREE AND CHARITABLE CLINICS, INC.

Petty Ricky

CONNECT TO GREATNESS, INC.

Bush Kemberly

BUSHMASTERS CLEANING SERVICES, LLC

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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