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COASTAL PSYCHIATRIC CENTER, INC. - Florida Company Profile

Company Details

Entity Name: COASTAL PSYCHIATRIC CENTER, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 07 Feb 2019 (6 years ago)
Last Event: AMENDMENT
Event Date Filed: 01 Jul 2019 (6 years ago)
Document Number: N19000001587
FEI/EIN Number 833655467

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 1335 VALENTINE ST, MELBOURNE, FL, 32901, US
Mail Address: 1335 VALENTINE ST, MELBOURNE, FL, 32901, US
ZIP code: 32901
County: Brevard
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1689231110 2019-05-21 2022-05-26 1335 VALENTINE ST, MELBOURNE, FL, 329013127, US 1335 VALENTINE ST, MELBOURNE, FL, 329013127, US

Contacts

Phone +1 321-586-5444
Fax 3213199712

Authorized person

Name JESSICA KARLE
Role EXECUTIVE DIRECTOR
Phone 3215865444

Taxonomy

Taxonomy Code 103TC0700X - Clinical Psychologist
Is Primary No
Taxonomy Code 2084P0800X - Psychiatry Physician
Is Primary No
Taxonomy Code 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center)
Is Primary Yes
Taxonomy Code 363LP0808X - Psychiatric/Mental Health Nurse Practitioner
Is Primary No

Other Provider Identifiers

Issuer MEDICAID
Number 109565100
State FL

Key Officers & Management

Name Role Address
KARLE JESSICA PH.D. Director 1335 VALENTINE ST, MELBOURNE, FL, 32901
Karle Stephen Officer 1335 VALENTINE ST, MELBOURNE, FL, 32901
KARLE JESSICA Agent 1335 VALENTINE ST, MELBOURNE, FL, 32901

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G19000042087 COASTAL PSYCHIATRIC URGENT CARE ACTIVE 2019-04-02 2029-12-31 - 1335 VALENTINE ST, MELBOURNE, FL, 32901

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2022-04-28 1335 VALENTINE ST, MELBOURNE, FL 32901 -
CHANGE OF MAILING ADDRESS 2022-04-28 1335 VALENTINE ST, MELBOURNE, FL 32901 -
REGISTERED AGENT ADDRESS CHANGED 2022-04-28 1335 VALENTINE ST, MELBOURNE, FL 32901 -
AMENDMENT 2019-07-01 - -

Documents

Name Date
ANNUAL REPORT 2024-03-29
ANNUAL REPORT 2023-03-19
ANNUAL REPORT 2022-04-28
ANNUAL REPORT 2021-01-12
ANNUAL REPORT 2020-03-11
Amendment 2019-07-01
Domestic Non-Profit 2019-02-07

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
83-3655467 Corporation Unconditional Exemption 1335 VALENTINE ST, MELBOURNE, FL, 32901-3127 2019-08
In Care of Name % JESSICA KARLE
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Hospital or medical research organization 170(b)(1)(A)(iii)
Tax Period 2024-06
Asset 100,000 to 499,999
Income 500,000 to 999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Jun
Asset Amount 131927
Income Amount 939967
Form 990 Revenue Amount 939967
National Taxonomy of Exempt Entities -
Sort Name -

Publication 78 Data

Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Determination Letter

Final Letter(s) FinalLetter_83-3655467_COASTALPSYCHIATRICCENTERINC_03202019_01.tif

Copies of Returns (990, 990-EZ, 990-PF, 990-T)

Organization Name COASTAL PSYCHIATRIC CENTER INC
EIN 83-3655467
Tax Period 202306
Filing Type E
Return Type 990
File View File
Organization Name COASTAL PSYCHIATRIC CENTER INC
EIN 83-3655467
Tax Period 202206
Filing Type E
Return Type 990
File View File
Organization Name COASTAL PSYCHIATRIC CENTER INC
EIN 83-3655467
Tax Period 202106
Filing Type E
Return Type 990
File View File
Organization Name COASTAL PSYCHIATRIC CENTER INC
EIN 83-3655467
Tax Period 202006
Filing Type E
Return Type 990
File View File

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
2883448507 2021-02-22 0455 PPS 1428 Valentine St, Melbourne, FL, 32901-3130
Loan Status Date 2021-11-16
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 63054
Loan Approval Amount (current) 63054
Undisbursed Amount 0
Franchise Name -
Lender Location ID 225134
Servicing Lender Name Truist Bank
Servicing Lender Address 214 N Tryon St, CHARLOTTE, NC, 28202-1078
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Melbourne, BREVARD, FL, 32901-3130
Project Congressional District FL-08
Number of Employees 6
NAICS code 621330
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 225134
Originating Lender Name Truist Bank
Originating Lender Address CHARLOTTE, NC
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 63469.11
Forgiveness Paid Date 2021-10-20
7251947807 2020-06-03 0455 PPP 1428 Valentine St, Melbourne, FL, 32901-3130
Loan Status Date 2021-05-19
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 45055.42
Loan Approval Amount (current) 45055.42
Undisbursed Amount 0
Franchise Name -
Lender Location ID 225134
Servicing Lender Name Truist Bank
Servicing Lender Address 214 N Tryon St, CHARLOTTE, NC, 28202-1078
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description New Business or 2 years or less
Project Address Melbourne, BREVARD, FL, 32901-3130
Project Congressional District FL-08
Number of Employees 3
NAICS code 621330
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 225134
Originating Lender Name Truist Bank
Originating Lender Address CHARLOTTE, NC
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 45404.6
Forgiveness Paid Date 2021-04-15

Date of last update: 02 Mar 2025

Sources: Florida Department of State