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  5. NORTHWEST BEHAVIORAL HEALTH SERVICES, INC.

NORTHWEST BEHAVIORAL HEALTH SERVICES, INC.

Company Details

Entity Name: NORTHWEST BEHAVIORAL HEALTH SERVICES, INC.
Jurisdiction: FLORIDA
Filing Type: Florida Not For Profit Corporation
Status: Active
Date Filed: 24 Jun 1992 (33 years ago)
Last Event: NAME CHANGE AMENDMENT
Event Date Filed: 08 Jan 1996 (29 years ago)
Document Number: N49538
FEI/EIN Number 59-3128476
Address: 2392 N. EDGEWOOD AVENUE, JACKSONVILLE, FL 32254
Mail Address: 2392 N Edgewood Ave, JACKSONVILLE, FL 32254
ZIP code: 32254
County: Duval
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1568636181 2008-04-15 2008-04-15 2392 EDGEWOOD AVE N, JACKSONVILLE, FL, 322541725, US 2392 EDGEWOOD AVE N, JACKSONVILLE, FL, 322541725, US

Contacts
Phone +1 904-781-7797
Fax 9048540506

Authorized person
Name MS. VERONICA GRIFFIN
Role CASE MANAGER
Phone 9047817797

Taxonomy
Taxonomy Code 251B00000X - Case Management Agency
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NORTHWEST BEHAVIORAL HEALTH SERVICES, INC. 2020 593128476 2021-04-13 NORTHWEST BEHAVIORAL HEALTH SERVICES, INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 624310
Sponsor’s telephone number 9047817797
Plan sponsor’s address 2392 N EDGEWOOD AVE, JACKSONVILLE, FL, 322541725

Signature of
Role Plan administrator
Date 2021-04-13
Name of individual signing M ELLEN BARNES
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-04-13
Name of individual signing M ELLEN BARNES
Valid signature Filed with authorized/valid electronic signature
NORTHWEST BEHAVIORAL HEALTH SERVICES, INC. EMPLOYEES SAVINGS 2020 593128476 2021-04-13 NORTHWEST BEHAVIORAL HEALTH SERVICES, INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 624310
Sponsor’s telephone number 9047817797
Plan sponsor’s address 2392 N EDGEWOOD AVE, JACKSONVILLE, FL, 322541725

Signature of
Role Plan administrator
Date 2021-04-13
Name of individual signing M ELLEN BARNES
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-04-13
Name of individual signing M ELLEN BARNES
Valid signature Filed with authorized/valid electronic signature
NORTHWEST BEHAVIORAL HEALTH SERVICES, INC. EMPLOYEES SAVINGS 2019 593128476 2020-08-14 NORTHWEST BEHAVIORAL HEALTH SERVICES, INC. 47
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 624310
Sponsor’s telephone number 9047817797
Plan sponsor’s address 2392 N EDGEWOOD AVE, JACKSONVILLE, FL, 322541725

Signature of
Role Plan administrator
Date 2020-08-14
Name of individual signing M ELLEN BARNES
Valid signature Filed with authorized/valid electronic signature
NORTHWEST BEHAVIORAL HEALTH SERVICES, INC. EMPLOYEES SAVINGS 2018 593128476 2019-10-02 NORTHWEST BEHAVIORAL HEALTH SERVICES, INC. 62
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 624310
Sponsor’s telephone number 9047817797
Plan sponsor’s address 2392 N EDGEWOOD AVE, JACKSONVILLE, FL, 322541725

Signature of
Role Plan administrator
Date 2019-10-02
Name of individual signing M ELLEN BARNES
Valid signature Filed with authorized/valid electronic signature
NORTHWEST BEHAVIORAL HEALTH SERVICES, INC. EMPLOYEES SAVINGS TRUST 2017 593128476 2018-10-02 NORTHWEST BEHAVIORAL HEALTH SERVICES, INC. 47
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 624310
Sponsor’s telephone number 9047817797
Plan sponsor’s address 2392 N EDGEWOOD AVE, JACKSONVILLE, FL, 322541725

Signature of
Role Plan administrator
Date 2018-10-02
Name of individual signing M. ELLEN BARNES
Valid signature Filed with authorized/valid electronic signature
NORTHWEST BEHAVIORAL HEALTH SERVICES, INC. EMPLOYEES SAVINGS TRUST 2016 593128476 2017-04-28 NORTHWEST BEHAVIORAL HEALTH SERVICES, INC. 54
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 624310
Sponsor’s telephone number 9047817797
Plan sponsor’s address 2392 N EDGEWOOD AVE, JACKSONVILLE, FL, 32254

Signature of
Role Plan administrator
Date 2017-04-28
Name of individual signing M. ELLEN BARNES
Valid signature Filed with authorized/valid electronic signature
NORTHWEST BEHAVIORAL HEALTH SERVICES, INC. EMPLOYEES SAVINGS TRUST 2015 593128476 2016-07-12 NORTHWEST BEHAVIORAL HEALTH SERVICES, INC. 54
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 624310
Sponsor’s telephone number 9047817797
Plan sponsor’s address 2392 N EDGEWOOD AVE, JACKSONVILLE, FL, 32254

Signature of
Role Plan administrator
Date 2016-07-12
Name of individual signing PATRICIA SAMPSON
Valid signature Filed with authorized/valid electronic signature
NORTHWEST BEHAVIORAL HEALTH SERVICES, INC. EMPLOYEES SAVINGS TRUST 2014 593128476 2015-04-21 NORTHWEST BEHAVIORAL HEALTH SERVICES, INC. 54
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 624310
Sponsor’s telephone number 9047817797
Plan sponsor’s address 2392 N EDGEWOOD AVE, JACKSONVILLE, FL, 32254

Signature of
Role Plan administrator
Date 2015-04-21
Name of individual signing PATRICIA SAMPSON
Valid signature Filed with authorized/valid electronic signature
NORTHWEST BEHAVIORAL HEALTH SERVICES, INC. EMPLOYEES SAVINGS TRUST 2013 593128476 2014-07-24 NORTHWEST BEHAVIORAL HEALTH SERVICES, INC. 53
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 624310
Sponsor’s telephone number 9047817797
Plan sponsor’s address 2392 N EDGEWOOD AVE, JACKSONVILLE, FL, 32254

Signature of
Role Plan administrator
Date 2014-07-24
Name of individual signing PATRICIA SAMPSON
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ESTELL, REGINALD J. Agent 303 N. Liberty Street, JACKSONVILLE, FL 32202

Chief Executive Officer

Name Role Address
GLOVER, TERRI D Chief Executive Officer 11 E FORSYTH ST, APT 301 Jacksonville, FL 32226

Vice President

Name Role Address
PARKER-BELL, BERNICE Vice President 10887 CHADRON DRIVE, Jacksonville, FL 32218

PRESIDENT

Name Role Address
HOPKINS, MELANIE PRESIDENT 303 N LIBERTY STREET, Jacksonville, FL 32202

Treasurer

Name Role Address
THOMAS, ODEAN Treasurer 8000 RAMSGATE RD, JACKSONVILLE, FL 32208

Secretary

Name Role Address
MAZEKE, KENTISHA Secretary 3908 VICTORIA LAKE DR, JACKSONVILLE, FL 32226

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2021-04-01 303 N. Liberty Street, JACKSONVILLE, FL 32202 No data
CHANGE OF MAILING ADDRESS 2020-04-10 2392 N. EDGEWOOD AVENUE, JACKSONVILLE, FL 32254 No data
REGISTERED AGENT NAME CHANGED 2018-04-23 ESTELL, REGINALD J. No data
NAME CHANGE AMENDMENT 1996-01-08 NORTHWEST BEHAVIORAL HEALTH SERVICES, INC. No data
CHANGE OF PRINCIPAL ADDRESS 1995-04-26 2392 N. EDGEWOOD AVENUE, JACKSONVILLE, FL 32254 No data

Debts

Document Number Status Case Number Name of Court Date of Entry Expiration Date Amount Due Plaintiff
J18000144774 LAPSED 16-2017-CC-010383-X DUVAL COUNTY COURT 2018-01-25 2023-04-12 $10,988.97 ADVANCED MD, INC., A DELAWARE CORPORATION, C/O SPRECHMAN & FISHER, P.A., 2775 SUNNY ISLES BLVD 100, NORTH MIAMI BEACH, FL 33160

Documents

Name Date
ANNUAL REPORT 2024-04-22
AMENDED ANNUAL REPORT 2023-10-13
AMENDED ANNUAL REPORT 2023-07-18
ANNUAL REPORT 2023-02-13
ANNUAL REPORT 2022-03-22
ANNUAL REPORT 2021-04-01
ANNUAL REPORT 2020-04-10
ANNUAL REPORT 2019-03-15
ANNUAL REPORT 2018-04-23
ANNUAL REPORT 2017-04-25

Related by officers

PARKER-BELL, BERNICE

ASSOCIATION OF BLACK PSYCHOLOGISTS INC. JACKSONVILLE CHAPTER

HOPKINS, MELANIE

COMPUTER SCIENCES GROUP, INC.

Related by address

No related companies by address

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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