| Entity Name: | ADVANCED CARE SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 20 Mar 2015 (10 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 28 Jun 2019 (6 years ago) |
| Document Number: | N15000002927 |
| FEI/EIN Number | 47-3214118 |
| Address: | 6151 MIRAMAR PARKWAY, SUITE 310, MIRAMAR, FL, 33023 |
| Mail Address: | 1620 NE 148th Street, North Miami, FL, 33181, US |
| ZIP code: | 33023 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902298128 | 2015-02-25 | 2024-03-07 | 1620 NE 148TH ST, NORTH MIAMI, FL, 331811021, US | 1620 NE 148TH ST, NORTH MIAMI, FL, 331811021, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 786-298-7379 |
| Phone | +1 305-705-6445 |
| Fax | 8888906583 |
Authorized person
| Name | DR. DAVID CORADIN |
| Role | CMO |
| Phone | 9545015274 |
Taxonomy
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000441500 |
| State | FL |
| Issuer | MEDICAID |
| Number | 006246600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WILLIAMS GERDA M | Agent | 1620 NE 148th Street, North Miami, FL, 33181 |
| Name | Role | Address |
|---|---|---|
| WILLIAMS GERDA M | Vice Chairman | 6151 MIRAMAR PARKWAY, SUITE 310, MIRAMAR, FL, 33023 |
| Name | Role | Address |
|---|---|---|
| Leno Terry | Chief Operating Officer | 1620 NE 148th Street, North Miami, FL, 33181 |
| Name | Role | Address |
|---|---|---|
| DUNN GAYON | Chief Executive Officer | 6151 MIRAMAR PARKWAY, MIRAMAR, FL, 33023 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000042985 | J &C HEALTHCARE CENTER | ACTIVE | 2021-03-29 | 2026-12-31 | No data | 1620 NE 148TH STEERY, NORTH MIAMI, FL, 33181 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2019-08-19 | 6151 MIRAMAR PARKWAY, SUITE 310, MIRAMAR, FL 33023 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-08-19 | 1620 NE 148th Street, North Miami, FL 33181 | No data |
| REINSTATEMENT | 2019-06-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2019-06-28 | WILLIAMS, GERDA M | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-23 |
| ANNUAL REPORT | 2023-02-07 |
| ANNUAL REPORT | 2022-02-21 |
| ANNUAL REPORT | 2021-04-08 |
| ANNUAL REPORT | 2020-01-13 |
| AMENDED ANNUAL REPORT | 2019-08-19 |
| REINSTATEMENT | 2019-06-28 |
| ANNUAL REPORT | 2016-04-30 |
| Domestic Non-Profit | 2015-03-20 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
