| Entity Name: | WELLSPRING MENTAL HEALTH GROUP, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 24 Oct 2018 (6 years ago) |
| Document Number: | N18000011397 |
| FEI/EIN Number | 83-2334820 |
| Address: | 1121 N DIXIE FREEWAY, NEW SMYRNA BEACH, FL, 32168, US |
| Mail Address: | 1121 n dixie freeway, NEW SMYRNA BEACH, 32168, UN |
| ZIP code: | 32168 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932669132 | 2019-03-22 | 2019-03-22 | 1982 SR 44, SUITE 194, NEW SMYRNA BEACH, FL, 32168, US | 1121 N DIXIE FWY, NEW SMYRNA BEACH, FL, 321686069, US | |||||||||||||||
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| Phone | +1 386-316-7462 |
| Phone | +1 386-410-3354 |
Authorized person
| Name | NATE INGRAM |
| Role | DIRECTOR |
| Phone | 3864103354 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| INGRAM NATHANIEL | Agent | 1121 n dixie freeway, NEW SMYRNA BEACH, FL, 32168 |
| Name | Role | Address |
|---|---|---|
| INGRAM Nathaniel P | SAA | 1982 SR 44 STE 194, NEW SMYRNA BEACH, FL, 32168 |
| Name | Role | Address |
|---|---|---|
| Ingram Kimberly M | President | 1121 N Dixie Freeway, New Smyrna Beach, FL, 32168 |
| Name | Role | Address |
|---|---|---|
| MILLER KAYLA M | Vice President | 1982 SR 44 STE 194, NEW SMYRNA BEACH, FL, 32168 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000052277 | WELLSPRING PORT ORANGE | ACTIVE | 2023-04-25 | 2028-12-31 | No data | 1121 N DIXIE FREEWAY, NEW SMYRNA BEACH, FL, 32168 |
| G19000089803 | THE WELLSPRING NSB | EXPIRED | 2019-08-21 | 2024-12-31 | No data | 1121 N DIXIE FREEWAY, NEW SMYRNA BEACH, FL, 32168 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-17 | 1121 N DIXIE FREEWAY, NEW SMYRNA BEACH, FL 32168 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-17 | 1121 N DIXIE FREEWAY, NEW SMYRNA BEACH, FL 32168 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-17 | 1121 n dixie freeway, NEW SMYRNA BEACH, FL 32168 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-17 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-04-30 |
| ANNUAL REPORT | 2021-05-01 |
| ANNUAL REPORT | 2020-04-30 |
| ANNUAL REPORT | 2019-05-01 |
| Domestic Non-Profit | 2018-10-24 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
