| Entity Name: | INTEGRATED HEALTHCARE SYSTEMS RIVIERA, 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: | 12 May 2020 (5 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 22 May 2023 (2 years ago) |
| Document Number: | N20000005065 |
| FEI/EIN Number |
851003540
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 31 W 20TH STREET, 100, RIVIERA BEACH, FL, 33404, US |
| Mail Address: | 31 W 20TH STREET, 100, RIVIERA BEACH, FL, 33404, US |
| ZIP code: | 33404 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053092148 | 2023-07-31 | 2023-07-31 | 31 W 20TH ST, RIVIERA BEACH, FL, 334046155, US | 31 W 20TH ST STE 200, RIVIERA BEACH, FL, 334046155, US | |||||||||||||||||||||||||||
|
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| Phone | +1 561-899-9140 |
| Fax | 5613312715 |
Authorized person
| Name | MONIQUE D BROWN FAUST |
| Role | EXECUTIVE DIRECTOR |
| Phone | 5618999140 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | Yes |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| WOODEN JAILYA J | President | 31 W 20TH STREET, RIVIERA BEACH, FL, 33404 |
| Rawleigh Tamika | Vice President | 31 W 20th Street, Riviera Beach, FL, 33404 |
| BROCKETT CLARENCE | Treasurer | 504 WOODBINE WAY, SUITE 504, PALM BEACH GARDENS, FL, 33418 |
| Brown Faust Monique D | Exec | 31 W 20TH STREET, RIVIERA BEACH, FL, 33404 |
| Spencer Alia | Secretary | 3200 Summit Blvd, West Palm Beach, FL, 33416 |
| Lewis Diane JDTH | Director | 3437 Avenue O, Riviera Beach, FL, 33404 |
| WOODEN JAILYA J | Agent | 31 W 20TH STREET, RIVIERA BEACH, FL, 33404 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000088352 | INTEGRATED HEALTHCARE SYSTEMS | ACTIVE | 2023-07-27 | 2028-12-31 | - | 31 W 20TH STREET, SUITE 100, RIVIERA BEACH, FL, 33404 |
| G22000075365 | INTEGRATED HEALTH CARE FOR DACOSTA YOUTH AND FAMILY | ACTIVE | 2022-06-22 | 2027-12-31 | - | 31 W 20TH STREET, SUITE 400, RIVIERA BEACH, FL, 33404 |
| G21000117840 | INTEGRATED HEALTHCARE SYSTEMS | ACTIVE | 2021-09-14 | 2026-12-31 | - | 31 W 20TH STREET, 200, RIVIERA BEACH, FL, 33404 |
| G21000049256 | INTEGRATED HEALTH SYSTEMS | ACTIVE | 2021-04-10 | 2026-12-31 | - | 31 W 20TH STREET, SUITE 100, RIVIERA BEACH, FL, 33404 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| NAME CHANGE AMENDMENT | 2023-05-22 | INTEGRATED HEALTHCARE SYSTEMS RIVIERA, INC | - |
| AMENDMENT | 2020-06-29 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-28 |
| Name Change | 2023-05-22 |
| ANNUAL REPORT | 2023-04-28 |
| ANNUAL REPORT | 2022-02-02 |
| ANNUAL REPORT | 2021-03-18 |
| Amendment | 2020-06-29 |
| Domestic Non-Profit | 2020-05-12 |
Date of last update: 02 Mar 2025
Sources: Florida Department of State
