| Entity Name: | THE HEALING IMPACT, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Not For Profit Corporation |
| Status: | Active |
| Date Filed: | 11 Apr 2019 (6 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 02 Dec 2024 (2 months ago) |
| Document Number: | N19000003799 |
| FEI/EIN Number | 83-4390969 |
| Address: | 5170 Annie Ruth St, MILTON, FL 32570 |
| Mail Address: | 5170 ANNIE RUTH STREET, MILTON, FL 32570 |
| ZIP code: | 32570 |
| County: | Santa Rosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154988772 | 2019-05-20 | 2021-09-30 | PO BOX 406, SHALIMAR, FL, 325790406, US | 4 9TH AVE STE F, SHALIMAR, FL, 325791742, US | |||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 505-412-5292 |
Authorized person
| Name | MRS. KAITLYN CHURCHMAN ABADIA |
| Role | CO-PRESIDENT |
| Phone | 8502183062 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1043853435 |
| State | FL |
| Issuer | NPI |
| Number | 1861792467 |
| Issuer | EMPLOYEE NPI |
| Number | 1013499664 |
| Issuer | NPI |
| Number | 1345573506 |
| State | FL |
| Issuer | NPI |
| Number | 1720560675 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ELLIS, AMY | Agent | 5170 ANNIE RUTH STREET, MILTON, FL 32570 |
| Name | Role | Address |
|---|---|---|
| ELLIS, HOWLAND | Officer | 5170 ANNIE RUTH STREET, MILTON, FL 32570 |
| Skinner, Denard | Officer | 5170 ANNIE RUTH STREET, MILTON, FL 32570 |
| Name | Role | Address |
|---|---|---|
| ELLIS, AMY | Chief Executive Officer | 5170 ANNIE RUTH STREET, FT WALTON BEACH, FL 32570 |
| Name | Role | Address |
|---|---|---|
| Accardi, Sloan | Board President | 5170 ANNIE RUTH STREET, MILTON, FL 32570 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-12-02 | ELLIS, AMY | No data |
| REINSTATEMENT | 2024-12-02 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| AMENDMENT | 2023-09-25 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-09-25 | 5170 ANNIE RUTH STREET, MILTON, FL 32570 | No data |
| CHANGE OF MAILING ADDRESS | 2023-09-25 | 5170 Annie Ruth St, MILTON, FL 32570 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-21 | 5170 Annie Ruth St, MILTON, FL 32570 | No data |
| CONVERSION | 2019-04-11 | No data | CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS L18000208363. CONVERSION NUMBER 300000191963 |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-12-02 |
| Amendment | 2023-09-25 |
| ANNUAL REPORT | 2023-07-18 |
| ANNUAL REPORT | 2022-04-21 |
| ANNUAL REPORT | 2021-04-13 |
| ANNUAL REPORT | 2020-03-29 |
| Domestic Non-Profit | 2019-04-11 |
Date of last update: 17 Jan 2025
Sources: Florida Department of State
