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  5. TREASURE COAST COMMUNITY HEALTH, INC.

TREASURE COAST COMMUNITY HEALTH, INC. - Florida Company Profile

Company Details

Entity Name: TREASURE COAST COMMUNITY HEALTH, 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: 08 Oct 1993 (32 years ago)
Last Event: NAME CHANGE AMENDMENT
Event Date Filed: 12 Jan 2005 (20 years ago)
Document Number: N93000004631
FEI/EIN Number 593219191

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 12196 CR 512, FELLSMERE, FL, 32948, US
Mail Address: 1555 INDIAN RIVER BLVD, SUITE B210, VERO BEACH, FL, 32960, US
ZIP code: 32948
County: Indian River
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1730931379 2024-04-05 2024-06-12 1545 9TH ST SW, VERO BEACH, FL, 329624312, US 1545 9TH ST SW, MEDICAL MOBILE UNIT, VERO BEACH, FL, 329624312, US

Contacts
Phone +1 772-257-8224

Authorized person
Name VICKI SOULE
Role CEO
Phone 7722578224

Taxonomy
Taxonomy Code 261QF0400X - Federally Qualified Health Center (FQHC)
Is Primary Yes

Legal Entity Identifier

LEI number Registered As Jurisdiction Of Formation General Category Entity Status Entity created at
549300M73VNPK31TH354 N93000004631 US-FL GENERAL ACTIVE -

Addresses
Legal C/O SOULE, VICKI, 1555 INDIAN RIVER BLVD, SUITE B210, VERO BEACH, US-FL, US, 32960
Headquarters 1555 Indian River Blvd, Ste B21, VERO BEACH, US-FL, US, 32960

Registration details
Registration Date 2021-02-15
Last Update 2023-08-04
Status LAPSED
Next Renewal 2022-02-13
LEI Issuer 5493001KJTIIGC8Y1R12
Corroboration Level FULLY_CORROBORATED
Data Validated As N93000004631

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TREASURE COAST COMMUNITY HEALTH, INC. 403(B) PLAN 2011 593219191 2012-10-15 TREASURE COAST COMMUNITY HEALTH, INC. 112
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 622000
Sponsor’s telephone number 7725718828
Plan sponsor’s address 12196 COUNTY ROAD 512, FELLSMERE, FL, 32948

Plan administrator’s name and address
Administrator’s EIN 593219191
Plan administrator’s name TREASURE COAST COMMUNITY HEALTH, INC.
Plan administrator’s address 12196 COUNTY ROAD 512, FELLSMERE, FL, 32948
Administrator’s telephone number 7725718828

Signature of
Role Plan administrator
Date 2012-10-15
Name of individual signing VICKI SOULE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-15
Name of individual signing VICKI SOULE
Valid signature Filed with authorized/valid electronic signature
TREASURE COAST COMMUNITY HEALTH, INC. 403(B) PLAN 2010 593219191 2011-10-14 TREASURE COAST COMMUNITY HEALTH, INC. 93
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 622000
Sponsor’s telephone number 7725718828
Plan sponsor’s address 12196 COUNTY ROAD 512, FELLSMERE, FL, 32948

Plan administrator’s name and address
Administrator’s EIN 593219191
Plan administrator’s name TREASURE COAST COMMUNITY HEALTH, INC.
Plan administrator’s address 12196 COUNTY ROAD 512, FELLSMERE, FL, 32948
Administrator’s telephone number 7725718828

Signature of
Role Plan administrator
Date 2011-10-14
Name of individual signing LINDA COSTA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-10-14
Name of individual signing LINDA COSTA
Valid signature Filed with authorized/valid electronic signature
TREASURE COAST COMMUNITY HEALTH, INC. 403(B) PLAN 2010 593219191 2011-12-23 TREASURE COAST COMMUNITY HEALTH, INC. 89
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 622000
Sponsor’s telephone number 7725718828
Plan sponsor’s address 12196 COUNTY ROAD 512, FELLSMERE, FL, 32948

Plan administrator’s name and address
Administrator’s EIN 593219191
Plan administrator’s name TREASURE COAST COMMUNITY HEALTH, INC.
Plan administrator’s address 12196 COUNTY ROAD 512, FELLSMERE, FL, 32948
Administrator’s telephone number 7725718828

Signature of
Role Plan administrator
Date 2011-12-22
Name of individual signing LINDA COSTA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-12-22
Name of individual signing LINDA COSTA
Valid signature Filed with authorized/valid electronic signature
TREASURE COAST COMMUNITY HEALTH, INC. 403(B) PLAN 2009 593219191 2011-12-23 TREASURE COAST COMMUNITY HEALTH, INC. 48
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 622000
Sponsor’s telephone number 7725718828
Plan sponsor’s address 12196 COUNTY ROAD 512, FELLSMERE, FL, 32948

Plan administrator’s name and address
Administrator’s EIN 593219191
Plan administrator’s name TREASURE COAST COMMUNITY HEALTH, INC.
Plan administrator’s address 12196 COUNTY ROAD 512, FELLSMERE, FL, 32948
Administrator’s telephone number 7725718828

Signature of
Role Plan administrator
Date 2011-12-22
Name of individual signing LINDA COSTA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-12-22
Name of individual signing LINDA COSTA
Valid signature Filed with authorized/valid electronic signature
TREASURE COAST COMMUNITY HEALTH, INC. 403(B) PLAN 2009 593219191 2010-10-15 TREASURE COAST COMMUNITY HEALTH, INC. 48
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 622000
Sponsor’s telephone number 7725718828
Plan sponsor’s address 12196 COUNTY ROAD 512, FELLSMERE, FL, 32948

Plan administrator’s name and address
Administrator’s EIN 593219191
Plan administrator’s name TREASURE COAST COMMUNITY HEALTH, INC.
Plan administrator’s address 12196 COUNTY ROAD 512, FELLSMERE, FL, 32948
Administrator’s telephone number 7725718828

Signature of
Role Plan administrator
Date 2010-10-15
Name of individual signing LINDA COSTA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-15
Name of individual signing LINDA COSTA
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
MILLER JUDI Chairman 1555 INDIAN RIVER BLVD, VERO BEACH, FL, 32960
Soule Vicki Chief Executive Officer 1555 INDIAN RIVER BLVD, VERO BEACH, FL, 32960
Fedock Andrea Chief Financial Officer 1555 INDIAN RIVER BLVD, VERO BEACH, FL, 32960
SOULE VICKI Agent 1555 INDIAN RIVER BLVD, VERO BEACH, FL, 32960

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2018-04-24 12196 CR 512, FELLSMERE, FL 32948 -
REGISTERED AGENT ADDRESS CHANGED 2018-04-24 1555 INDIAN RIVER BLVD, SUITE B210, VERO BEACH, FL 32960 -
REGISTERED AGENT NAME CHANGED 2015-04-29 SOULE, VICKI -
NAME CHANGE AMENDMENT 2005-01-12 TREASURE COAST COMMUNITY HEALTH, INC. -
CHANGE OF PRINCIPAL ADDRESS 1998-02-04 12196 CR 512, FELLSMERE, FL 32948 -
AMENDMENT 1994-11-21 - -

Documents

Name Date
ANNUAL REPORT 2024-03-01
ANNUAL REPORT 2023-04-26
ANNUAL REPORT 2022-04-27
ANNUAL REPORT 2021-04-05
ANNUAL REPORT 2020-03-23
ANNUAL REPORT 2019-04-12
ANNUAL REPORT 2018-04-24
ANNUAL REPORT 2017-04-26
ANNUAL REPORT 2016-04-29
ANNUAL REPORT 2015-04-29

USAspending Awards. Financial Assistance

FAIN Awarding Agency Assistance Listings Start Date End Date Description
C81CS13464 Department of Health and Human Services 93.703 - ARRA – GRANTS TO HEALTH CENTER PROGRAMS 2009-06-29 2011-06-28 ARRA - CAPITAL IMPROVEMENT PROGRAM
Recipient TREASURE COAST COMMUNITY HEALTH, INC.
Recipient Name Raw TREASURE COAST COMMUNITY HEALTH, INC.
Recipient UEI E1KKEFB36MU1
Recipient DUNS 045864175
Recipient Address 12196 CR 152, FELLSMERE, INDIAN RIVER, FLORIDA, 32948, UNITED STATES
Obligated Amount 536720.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
H8BCS12548 Department of Health and Human Services 93.703 - ARRA – GRANTS TO HEALTH CENTER PROGRAMS 2009-03-27 2011-03-26 ARRA - INCREASE SERVICES TO HEALTH CENTERS
Recipient TREASURE COAST COMMUNITY HEALTH, INC.
Recipient Name Raw TREASURE COAST COMMUNITY HEALTH, INC.
Recipient UEI E1KKEFB36MU1
Recipient DUNS 045864175
Recipient Address 12196 CR 152, FELLSMERE, INDIAN RIVER, FLORIDA, 32948, UNITED STATES
Obligated Amount 243670.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
H80CS00187 Department of Health and Human Services 93.224 - CONSOLIDATED HEALTH CENTERS (COMMUNITY HEALTH CENTERS, MIGRANT HEALTH CENTERS, HEALTH CARE FOR THE HOMELESS, PUBLIC HOUSING PRIMARY CARE, AND SCHOOL BASED HEALTH CENTERS) 2002-01-01 2010-12-31 HEALTH CENTER CLUSTER
Recipient TREASURE COAST COMMUNITY HEALTH, INC.
Recipient Name Raw TREASURE COAST COMMUNITY HEALTH, INC.
Recipient UEI E1KKEFB36MU1
Recipient DUNS 045864175
Recipient Address 12196 CR 152, FELLSMERE, INDIAN RIVER, FLORIDA, 32948
Obligated Amount 30213375.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
59-3219191 Corporation Unconditional Exemption 12196 COUNTY ROAD 512, FELLSMERE, FL, 32948-5463 1995-01
In Care of Name % ANDREA FEDOCK
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 2023-12
Asset 10,000,000 to 49,999,999
Income 10,000,000 to 49,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 26875146
Income Amount 34924806
Form 990 Revenue Amount 34924806
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)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name TREASURE COAST COMMUNITY HEALTH INC
EIN 59-3219191
Tax Period 202212
Filing Type E
Return Type 990
File View File
Organization Name TREASURE COAST COMMUNITY HEALTH INC
EIN 59-3219191
Tax Period 202112
Filing Type E
Return Type 990
File View File
Organization Name TREASURE COAST COMMUNITY HEALTH INC
EIN 59-3219191
Tax Period 201912
Filing Type E
Return Type 990
File View File
Organization Name TREASURE COAST COMMUNITY HEALTH INC
EIN 59-3219191
Tax Period 201812
Filing Type E
Return Type 990
File View File
Organization Name TREASURE COAST COMMUNITY HEALTH INC
EIN 59-3219191
Tax Period 201712
Filing Type E
Return Type 990
File View File
Organization Name TREASURE COAST COMMUNITY HEALTH INC
EIN 59-3219191
Tax Period 201612
Filing Type E
Return Type 990
File View File
Organization Name TREASURE COAST COMMUNITY HEALTH INC
EIN 59-3219191
Tax Period 201512
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
2943207207 2020-04-16 0455 PPP 1555 INDIAN RIVER BLVD B210, VERO BEACH, FL, 32960-7113
Loan Status Date 2021-07-21
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 2671570
Loan Approval Amount (current) 2671570
Undisbursed Amount 0
Franchise Name -
Lender Location ID 117723
Servicing Lender Name SouthState Bank, National Association
Servicing Lender Address 1101 First St South, WINTER HAVEN, FL, 33880-3908
Rural or Urban Indicator U
Hubzone N
LMI Y
Business Age Description Existing or more than 2 years old
Project Address VERO BEACH, INDIAN RIVER, FL, 32960-7113
Project Congressional District FL-08
Number of Employees 276
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 117723
Originating Lender Name SouthState Bank, National Association
Originating Lender Address WINTER HAVEN, FL
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 2701328.32
Forgiveness Paid Date 2021-06-09
2606748603 2021-03-15 0455 PPS 12196 County Road 512 N/A, Fellsmere, FL, 32948-5463
Loan Status Date 2022-02-18
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 2000000
Loan Approval Amount (current) 2000000
Undisbursed Amount 0
Franchise Name -
Lender Location ID 117723
Servicing Lender Name SouthState Bank, National Association
Servicing Lender Address 1101 First St South, WINTER HAVEN, FL, 33880-3908
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Fellsmere, INDIAN RIVER, FL, 32948-5463
Project Congressional District FL-08
Number of Employees 251
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 117723
Originating Lender Name SouthState Bank, National Association
Originating Lender Address WINTER HAVEN, FL
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 2016111.11
Forgiveness Paid Date 2022-01-18

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Fedock Andrea

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SOULE VICKI

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Companies related by address

1555 INDIAN RIVER BLVD, SUITE B210, VERO BEACH, FL, 32960, US

TREASURE COAST COMMUNITY HEALTH FOUNDATION, INC. 1545 9TH STREET SW HOLDINGS, LLC

Date of last update: 01 Apr 2025

Sources: Florida Department of State

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