| Entity Name: | SECOND CHANCE OF NORTHWEST FLORIDA, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 10 Jan 1992 (33 years ago) |
| Document Number: | N46767 |
| FEI/EIN Number | 593094842 |
| Address: | 819 E. 11th Street, Bldg. #4, PANAMA CITY, FL, 32401, US |
| Mail Address: | P.O. Box 285, PANAMA CITY, FL, 32402, US |
| ZIP code: | 32401 |
| County: | Bay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114309333 | 2015-06-24 | 2015-06-24 | 819 E 11TH ST, PANAMA CITY, FL, 324013459, US | 819 E 11TH ST, PANAMA CITY, FL, 324013459, US | |||||||||||||||||||||
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| Phone | +1 850-769-7779 |
| Fax | 8502157718 |
Authorized person
| Name | MR. JON CUPP |
| Role | DIRECTOR |
| Phone | 8507697779 |
Taxonomy
| Taxonomy Code | 251C00000X - Developmentally Disabled Services Day Training Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | PENDING |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Miller Ellen | Agent | 3980 L Arbour Trace Drive, Panama City, FL, 32444 |
| Name | Role | Address |
|---|---|---|
| FRENCH NITA | Secretary | 2815 LONGLEAF ROAD, PANAMA CITY, FL, 32405 |
| Name | Role | Address |
|---|---|---|
| FRENCH NITA | Director | 2815 LONGLEAF ROAD, PANAMA CITY, FL, 32405 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2020-02-10 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
