| Entity Name: | COASTAL REHABILITATION AND TREATMENT SERVICES, INCORPORATED |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Inactive |
| Date Filed: | 21 Oct 2009 (15 years ago) |
| Date of dissolution: | 25 Sep 2020 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 years ago) |
| Document Number: | N09000010264 |
| FEI/EIN Number | 271161019 |
| Mail Address: | 114 APALACHEE STREET, CARRABELLE, FL, 32322 |
| Address: | 3295 Crawfordville Highway, Crawfordville, FL, 32327, US |
| ZIP code: | 32327 |
| County: | Wakulla |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245562347 | 2010-02-01 | 2017-03-09 | 114 APALACHEE STREET, CARRABELLE, FL, 323223524, US | 3295 CRAWFORDVILLE HWY, CRAWFORDVILLE, FL, 323273150, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 850-566-0037 |
| Fax | 8506973891 |
Authorized person
| Name | ANNE BISHOP MORGAN |
| Role | CHIEF EXECUTIVE OFFICER |
| Phone | 8505660037 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| License Number | 0219AD101900 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 261QC1500X - Community Health Clinic/Center |
| License Number | 0219AD101900 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 002056000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MORGAN ANNE | Agent | 114 APALACHEE STREET, CARRABELLE, FL, 32322 |
| Name | Role | Address |
|---|---|---|
| MORGAN ANNE | Chief Executive Officer | 114 APALACHEE STREET, CARRABELLE, FL, 32322 |
| Name | Role | Address |
|---|---|---|
| GORDON LISBETH A | Director | 114 Apalachee Street, Carrabelle, FL, 32322 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-01-25 | 3295 Crawfordville Highway, Crawfordville, FL 32327 | No data |
| AMENDMENT | 2013-06-03 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-04-10 |
| ANNUAL REPORT | 2018-04-06 |
| ANNUAL REPORT | 2017-05-05 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-01-11 |
| ANNUAL REPORT | 2014-04-17 |
| ANNUAL REPORT | 2013-04-15 |
| ANNUAL REPORT | 2012-01-17 |
| ANNUAL REPORT | 2011-02-11 |
| Off/Dir Resignation | 2010-12-03 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
