| Entity Name: | CELEBRATE LIFE RECOVERY CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Not For Profit Corporation |
| Status: | Inactive |
| Date Filed: | 08 Sep 2009 (15 years ago) |
| Date of dissolution: | 23 Sep 2011 (13 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2011 (13 years ago) |
| Document Number: | N09000008745 |
| FEI/EIN Number | 27-0722932 |
| Address: | 850 W. DANIA BEACH BLVD., DANIA BEACH, FL 33004 |
| Mail Address: | 10650 NW 30 PL, BLDG #8, SUNRISE, FL 33322 |
| ZIP code: | 33004 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1720317282 | 2009-12-12 | 2010-09-16 | 850 W DANIA BEACH BLVD, DANIA BEACH, FL, 330043330, US | 850 W DANIA BEACH BLVD, DANIA BEACH, FL, 330043330, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 954-921-7535 |
| Fax | 9543465788 |
Authorized person
| Name | MRS. VALERIE CHANDLER |
| Role | PRESIDENT |
| Phone | 8772052906 |
Taxonomy
| Taxonomy Code | 101YA0400X - Addiction (Substance Use Disorder) Counselor |
| License Number | ME52952 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | ME52952 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 102L00000X - Psychoanalyst |
| License Number | ME52952 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 106H00000X - Marriage & Family Therapist |
| License Number | ME52952 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 251B00000X - Case Management Agency |
| License Number | 2215A |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| License Number | 2215A |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | ME52952 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| License Number | ME52952 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 261QR0800X - Recovery Care Clinic/Center |
| License Number | 2215A |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 302R00000X - Health Maintenance Organization |
| License Number | 2215A |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 305R00000X - Preferred Provider Organization |
| License Number | ME52952 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 305S00000X - Point of Service |
| License Number | 2215A |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 305S00000X - Point of Service |
| License Number | ME52952 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| CHANDLER, VALERIE | Agent | 10650 NW 30 PL, BLDG #8, SUNRISE, FL 33322 |
| Name | Role | Address |
|---|---|---|
| CHANDLER, VALERIE | President | 10650 NW 30 PL, SUNRISE, FL 33322 |
| Name | Role | Address |
|---|---|---|
| CUNNINGHAM, RALPH | Vice President | 4041 NW 8 TERRACE, OAKLAND PARK, FL 33309 |
| Name | Role | Address |
|---|---|---|
| STEWART, NAOMI | Secretary | 8977 NW 49 PL, CORAL SPRINGS, FL 33067 |
| Name | Role | Address |
|---|---|---|
| MOORE, MATHIS | Chief Executive Officer | 10650 NW 30 PL, BLDG 8, SUNRISE, FL 33322 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| AMENDMENT | 2010-10-12 | No data | No data |
| AMENDMENT | 2010-10-04 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-03-16 | 850 W. DANIA BEACH BLVD., DANIA BEACH, FL 33004 | No data |
| AMENDMENT | 2010-03-05 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2010-01-06 | 850 W. DANIA BEACH BLVD., DANIA BEACH, FL 33004 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-01-06 | 10650 NW 30 PL, BLDG #8, SUNRISE, FL 33322 | No data |
| Name | Date |
|---|---|
| Amendment | 2010-10-12 |
| Amendment | 2010-10-04 |
| ADDRESS CHANGE | 2010-03-16 |
| Amendment | 2010-03-05 |
| ANNUAL REPORT | 2010-01-06 |
| Domestic Non-Profit | 2009-09-08 |
Date of last update: 25 Jan 2025
Sources: Florida Department of State
