| Entity Name: | THE CENTER FOR PROGRESS AND EXCELLENCE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Not For Profit Corporation |
| Status: | Active |
| Date Filed: | 31 Jul 2014 (10 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 24 Aug 2020 (4 years ago) |
| Document Number: | N14000007168 |
| FEI/EIN Number | 47-4810710 |
| Address: | 1500 Colonial Blvd., Suite 233, FORT MYERS, FL 33907 |
| Mail Address: | 1500 Colonial Blvd., Suite 233, FORT MYERS, FL 33907 |
| ZIP code: | 33907 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861907339 | 2017-12-06 | 2020-07-28 | 11940 FAIRWAY LAKES DR STE 4, FORT MYERS, FL, 339138385, US | 11940 FAIRWAY LAKES DR STE 4, FORT MYERS, FL, 339138385, US | |||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 239-689-8490 |
| Fax | 2396898103 |
Authorized person
| Name | JAN-PAUL MOJICA |
| Role | CEO |
| Phone | 2396898490 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QM0855X - Adolescent and Children Mental Health Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 010785500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MOON, JASON | Agent | 4310 METRO PARKWAY, SUITE 205, FT. MYERS, FL 33916 |
| Name | Role | Address |
|---|---|---|
| MOON, JASON | C D | 1500 Colonial Blvd., Suite 233 FORT MYERS, FL 33907 |
| Name | Role | Address |
|---|---|---|
| DOSORETZ, ELIZABETH | VP D | 1500 Colonial Blvd., Suite 233 FORT MYERS, FL 33907 |
| Name | Role | Address |
|---|---|---|
| FOX, DR. AMY | T D | 1500 Colonial Blvd., Suite 233 FORT MYERS, FL 33907 |
| Name | Role | Address |
|---|---|---|
| DOSORETZ, DR. ARIE | S D | 1500 Colonial Blvd., Suite 233 FORT MYERS, FL 33907 |
| Name | Role | Address |
|---|---|---|
| Cross, Heather | Chief Executive Officer | 1500 Colonial Blvd., Suite 233 FORT MYERS, FL 33907 |
| Name | Role | Address |
|---|---|---|
| Mojica, Jan-Paul | LCSW | 11940 Fairway Lakes Drive, Suite 4 Fort Myers, FL 33913 |
| Name | Role | Address |
|---|---|---|
| Mojica, Jan-Paul | Board Member | 11940 Fairway Lakes Drive, Suite 4 Fort Myers, FL 33913 |
| Cirrone, Philip | Board Member | 4310 Metro Pkwy, Suite 205 Fort Myers, FL 33916 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000101722 | CRISIS PREVENTION & EMPOWERMENT | ACTIVE | 2024-08-26 | 2029-12-31 | No data | 1500 COLONIAL BLVD, SUITE 233, FORT MYERS, FL, 33907 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-03-17 | 1500 Colonial Blvd., Suite 233, FORT MYERS, FL 33907 | No data |
| CHANGE OF MAILING ADDRESS | 2022-03-17 | 1500 Colonial Blvd., Suite 233, FORT MYERS, FL 33907 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-08-24 | 4310 METRO PARKWAY, SUITE 205, FT. MYERS, FL 33916 | No data |
| AMENDMENT | 2020-08-24 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-08-24 | MOON, JASON | No data |
| AMENDMENT | 2018-11-26 | No data | No data |
| REINSTATEMENT | 2016-11-04 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-11 |
| ANNUAL REPORT | 2023-01-27 |
| ANNUAL REPORT | 2022-03-17 |
| ANNUAL REPORT | 2021-04-22 |
| Amendment | 2020-08-24 |
| ANNUAL REPORT | 2020-03-24 |
| ANNUAL REPORT | 2019-02-14 |
| Reg. Agent Change | 2019-01-14 |
| Amendment | 2018-11-26 |
| ANNUAL REPORT | 2018-01-26 |
Date of last update: 21 Jan 2025
Sources: Florida Department of State
