| Entity Name: | ALAS FAMILY SUPPORT CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 14 Sep 2012 (12 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 27 Sep 2017 (7 years ago) |
| Document Number: | N12000008838 |
| FEI/EIN Number | 46-0947937 |
| Address: | 16652 SW WARFIELD BLVD, INDIANTOWN, FL, 34956, US |
| Mail Address: | 14280 S Military Trl, Delray Beach, FL, 33482, US |
| ZIP code: | 34956 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265909287 | 2018-10-29 | 2018-10-29 | 16652 SW WARFIELD BLVD, INDIANTOWN, FL, 349564407, US | 16652 SW WARFIELD BLVD, INDIANTOWN, FL, 349564407, US | |||||||||||||||||||||||||
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| Phone | +1 772-248-2291 |
| Fax | 7722482298 |
Authorized person
| Name | BLANCA M DE REYES |
| Role | CEO |
| Phone | 7722482291 |
Taxonomy
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | Yes |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 717325 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DE Reyes BLANCA M | Agent | 16652 SW WARFIELD BLVD, INDIANTOWN, FL, 34956 |
| Name | Role | Address |
|---|---|---|
| CHANG CELIA | Vice President | 16652 SW WARFIELD BLVD, INDIANTOWN, FL, 34956 |
| REYES JORGE | Vice President | 16652 SW WARFIELD BLVD, INDIANTOWN, FL, 34956 |
| Name | Role | Address |
|---|---|---|
| DE REYES BLANCA M | President | 16652 SW WARFIELD BLVD, INDIANTOWN, FL, 34956 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-04-17 | 16652 SW WARFIELD BLVD, INDIANTOWN, FL 34956 | No data |
| REGISTERED AGENT NAME CHANGED | 2019-05-08 | DE Reyes, BLANCA M | No data |
| AMENDMENT | 2018-10-01 | No data | No data |
| REINSTATEMENT | 2017-09-27 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| AMENDMENT | 2013-02-28 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-17 |
| ANNUAL REPORT | 2023-08-04 |
| ANNUAL REPORT | 2022-05-02 |
| ANNUAL REPORT | 2021-05-17 |
| ANNUAL REPORT | 2020-06-22 |
| ANNUAL REPORT | 2019-05-08 |
| DEBIT MEMO# 035067-A | 2019-02-26 |
| Amendment | 2018-10-01 |
| ANNUAL REPORT | 2018-05-09 |
| REINSTATEMENT | 2017-09-27 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
