| Entity Name: | FAMILY FIRST COMMUNITY OUTREACH SERVICES INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 10 Apr 2017 (8 years ago) |
| Document Number: | N17000003916 |
| FEI/EIN Number | 82-1165933 |
| Address: | 5700 Lake Worth Road, Greenacres, FL, 33463, US |
| Mail Address: | 14611 Southern Blvd, Loxahatchee, FL, 33470, US |
| ZIP code: | 33463 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164956561 | 2017-04-12 | 2020-01-27 | 14611 SOUTHERN BLVD UNIT 412, LOXAHATCHEE, FL, 334706819, US | 2006 CROSS BREEZE DR, WELLINGTON, FL, 334148075, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 561-320-4053 |
Authorized person
| Name | CHRISTIANE PREVILMA |
| Role | CEO |
| Phone | 5613204053 |
Taxonomy
| Taxonomy Code | 163WC1500X - Community Health Registered Nurse |
| Is Primary | Yes |
| Taxonomy Code | 163WL0100X - Lactation Consultant (Registered Nurse) |
| Is Primary | No |
| Taxonomy Code | 163WP0200X - Pediatric Registered Nurse |
| Is Primary | No |
| Taxonomy Code | 364SP0200X - Pediatric Clinical Nurse Specialist |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| PREVILMA CHRISTIANE | Agent | 14611 Southern Blvd, Loxahatchee, FL, 33470 |
| Name | Role | Address |
|---|---|---|
| PANTOLIANO EILEEN | Treasurer | 14611 Southern Blvd, Loxahatchee, FL, 33470 |
| Name | Role | Address |
|---|---|---|
| Previlma Christiane | Chief Executive Officer | 14611 Southern Blvd, Loxahatchee, FL, 33470 |
| Name | Role | Address |
|---|---|---|
| Dickoff Christina | Boar | 14611 Southern Blvd, Loxahatchee, FL, 33470 |
| Zafir Simara | Boar | 14611 Southern Blvd, Loxahatchee, FL, 33470 |
| Stacy Kokel | Boar | 14611 Southern Blvd, Loxahatchee, FL, 33470 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000069871 | GATEWAY CASE MANAGEMENT SERVICES | EXPIRED | 2019-06-20 | 2024-12-31 | No data | 14611 SOUTHERN BLVD #412, LOXAHATCHEE, FL, 33470 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-01-18 | 5700 Lake Worth Road, 201-A, Greenacres, FL 33463 | No data |
| CHANGE OF MAILING ADDRESS | 2018-02-28 | 5700 Lake Worth Road, 201-A, Greenacres, FL 33463 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-02-28 | 14611 Southern Blvd, #412, Loxahatchee, FL 33470 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-11 |
| ANNUAL REPORT | 2023-01-18 |
| ANNUAL REPORT | 2022-02-11 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-02-07 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-02-28 |
| Domestic Non-Profit | 2017-04-10 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
