| Entity Name: | IMPACT'S TRANSITIONAL LIFE-SKILL CENTER INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 12 Apr 2017 (8 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 14 May 2018 (7 years ago) |
| Document Number: | N17000003985 |
| FEI/EIN Number | 821167924 |
| Mail Address: | 6004 ADAGIO LANE, APOLLO BEACH, FL, 33572, US |
| Address: | 909 BRYAN RD, BRANDON, FL, 33511, US |
| ZIP code: | 33511 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669992400 | 2017-06-22 | 2022-07-21 | 909 BRYAN RD, BRANDON, FL, 335116145, US | 909 BRYAN RD, BRANDON, FL, 335116145, US | |||||||||||||||||||||
|
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| Phone | +1 813-693-5101 |
Authorized person
| Name | KATHY GROSS |
| Role | VICE PRESIDENT |
| Phone | 8136935101 |
Taxonomy
| Taxonomy Code | 251C00000X - Developmentally Disabled Services Day Training Agency |
| Is Primary | No |
| Taxonomy Code | 261QA0600X - Adult Day Care Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 385H00000X - Respite Care |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| STIBICH JASON | Agent | 282 APOLLO BEACH BLVD, APOLLO BEACH, FL, 33572 |
| Name | Role | Address |
|---|---|---|
| STIBICH COLETTE | President | 6004 ADAGIO LN, APOLLO BEACH, FL, 33572 |
| Name | Role | Address |
|---|---|---|
| GROSS KATHY | Vice President | 935 BALSAMINA DR, BRANDON, FL, 33510 |
| Name | Role | Address |
|---|---|---|
| BELTON DANIEL | Trustee | 1423 NEW BRITAN DR, BRANDON, FL, 33511 |
| DOYLE TERRY | Trustee | 511 MARINA CT., SMITHVILLE, MD, 64089 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000156782 | ACTIVE ADULT CARE LLC | ACTIVE | 2021-11-24 | 2026-12-31 | No data | 909 BRYAN ROAD, BRANDON, FL, 33511 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2021-09-29 | 909 BRYAN RD, BRANDON, FL 33511 | No data |
| AMENDMENT | 2018-05-14 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-05-14 | 909 BRYAN RD, BRANDON, FL 33511 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-19 |
| ANNUAL REPORT | 2023-01-19 |
| ANNUAL REPORT | 2022-02-10 |
| ANNUAL REPORT | 2021-04-20 |
| ANNUAL REPORT | 2020-04-23 |
| ANNUAL REPORT | 2019-02-07 |
| Amendment | 2018-05-14 |
| ANNUAL REPORT | 2018-04-24 |
| Domestic Non-Profit | 2017-04-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
