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KRISTI HOUSE, INC.

Company Details

Entity Name: KRISTI HOUSE, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active
Date Filed: 20 Apr 1995 (30 years ago)
Document Number: N95000001885
FEI/EIN Number 650576650
Address: 1265 NW 12TH AVE, MIAMI, FL, 33136-2140, US
Mail Address: 1265 NW 12TH AVE, MIAMI, FL, 33136
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1336540129 2014-09-11 2014-09-11 1265 NW 12TH AVE, MIAMI, FL, 331362140, US 1265 NW 12TH AVE, MIAMI, FL, 331362140, US

Contacts
Phone +1 305-547-6800

Authorized person
Name GERTRUDE NOVICKI
Role EXECUTIVE DIRECTOR
Phone 3055476836

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

Other Provider Identifiers
Issuer MEDICAID
Number 009848700
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
KRISTI HOUSE, INC. 401(K) PROFIT SHARING PLAN 2020 650576650 2022-04-18 KRISTI HOUSE, INC. 71
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-07-01
Business code 813000
Sponsor’s telephone number 3055476800
Plan sponsor’s address 1265 NW 12 AVENUE, MIAMI, FL, 33136

Signature of
Role Plan administrator
Date 2022-04-18
Name of individual signing AMANDA ALTMAN
Valid signature Filed with authorized/valid electronic signature
KRISTI HOUSE, INC. 401(K) PROFIT SHARING PLAN 2019 650576650 2022-04-12 KRISTI HOUSE, INC. 58
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-07-01
Business code 813000
Sponsor’s telephone number 3055476800
Plan sponsor’s address 1265 NW 12 AVENUE, MIAMI, FL, 33136

Signature of
Role Plan administrator
Date 2022-04-12
Name of individual signing AMANDA ALTMAN
Valid signature Filed with authorized/valid electronic signature
KRISTI HOUSE, INC. 401(K) PROFIT SHARING PLAN 2018 650576650 2020-04-15 KRISTI HOUSE, INC. 63
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-07-01
Business code 813000
Sponsor’s telephone number 3055476800
Plan sponsor’s address 1265 NW 12 AVENUE, MIAMI, FL, 33136

Signature of
Role Plan administrator
Date 2020-04-15
Name of individual signing AMANDA ALTMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-04-15
Name of individual signing AMANDA ALTMAN
Valid signature Filed with authorized/valid electronic signature
KRISTI HOUSE, INC. 401(K) PROFIT SHARING PLAN 2017 650576650 2018-12-19 KRISTI HOUSE, INC. 56
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-07-01
Business code 813000
Sponsor’s telephone number 3055476800
Plan sponsor’s address 1265 NW 12 AVENUE, MIAMI, FL, 33136

Signature of
Role Plan administrator
Date 2018-12-19
Name of individual signing CLAUDIA KITCHENS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-12-19
Name of individual signing KRISTI HOUSE, INC.
Valid signature Filed with authorized/valid electronic signature
KRISTI HOUSE, INC. 401(K) PROFIT SHARING PLAN 2014 650576650 2015-12-02 KRISTI HOUSE, INC. 52
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-07-01
Business code 813000
Sponsor’s telephone number 3055476800
Plan sponsor’s address 1265 NW 12 AVENUE, MIAMI, FL, 33136

Signature of
Role Plan administrator
Date 2015-12-02
Name of individual signing CLAUDIA KITCHENS
Valid signature Filed with authorized/valid electronic signature
KRISTI HOUSE, INC. 401(K) PROFIT SHARING PLAN 2013 650576650 2014-10-29 KRISTI HOUSE, INC. 44
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-07-01
Business code 813000
Sponsor’s telephone number 3055476800
Plan sponsor’s address 1265 NW 12 AVENUE, MIAMI, FL, 33136

Signature of
Role Plan administrator
Date 2014-10-29
Name of individual signing TRUDY NOVICKI
Valid signature Filed with authorized/valid electronic signature
KRISTI HOUSE, INC. 401(K) PROFIT SHARING PLAN 2012 650576650 2014-03-07 KRISTI HOUSE, INC. 41
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-07-01
Business code 813000
Sponsor’s telephone number 3055476800
Plan sponsor’s address 1265 NW 12 AVENUE, MIAMI, FL, 33136

Signature of
Role Plan administrator
Date 2014-03-07
Name of individual signing TRUDY NOVICKI
Valid signature Filed with authorized/valid electronic signature
KRISTI HOUSE, INC. 401(K) PROFIT SHARING PLAN 2011 650576650 2013-06-17 KRISTI HOUSE, INC. 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-07-01
Business code 813000
Sponsor’s telephone number 3055476800
Plan sponsor’s address 1265 NW 12 AVENUE, MIAMI, FL, 33136

Plan administrator’s name and address
Administrator’s EIN 650576650
Plan administrator’s name KRISTI HOUSE, INC.
Plan administrator’s address 1265 NW 12 AVENUE, MIAMI, FL, 33136
Administrator’s telephone number 3055476800

Signature of
Role Plan administrator
Date 2013-06-17
Name of individual signing TRUDY NOVICKI
Valid signature Filed with authorized/valid electronic signature
KRISTI HOUSE, INC. 401(K) PROFIT SHARING PLAN 2010 650576650 2012-04-16 KRISTI HOUSE, INC. 44
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-07-01
Business code 813000
Sponsor’s telephone number 3055476800
Plan sponsor’s address 1265 NW 12 AVENUE, MIAMI, FL, 33136

Plan administrator’s name and address
Administrator’s EIN 650576650
Plan administrator’s name KRISTI HOUSE, INC.
Plan administrator’s address 1265 NW 12 AVENUE, MIAMI, FL, 33136
Administrator’s telephone number 3055476800

Signature of
Role Plan administrator
Date 2012-04-16
Name of individual signing TRUDY NOVICKI
Valid signature Filed with authorized/valid electronic signature
KRISTI HOUSE, INC. 401(K) PROFIT SHARING PLAN 2009 650576650 2011-01-31 KRISTI HOUSE, INC. 46
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-07-01
Business code 813000
Sponsor’s telephone number 3055476800
Plan sponsor’s address 1265 NW 12 AVENUE, MIAMI, FL, 33136

Plan administrator’s name and address
Administrator’s EIN 650576650
Plan administrator’s name KRISTI HOUSE, INC.
Plan administrator’s address 1265 NW 12 AVE., MIAMI, FL, 33136
Administrator’s telephone number 3055476800

Signature of
Role Plan administrator
Date 2011-01-31
Name of individual signing TRUDY NOVICKI
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Altman Amanda GEsq. Agent 1265 NW 12TH AVE, MIAMI, FL, 33136

Vice President

Name Role Address
Love Jennifer Vice President 1265 NW 12TH AVE, MIAMI, FL, 33136

President

Name Role Address
Potamkin Alan President 1265 NW 12TH AVE, MIAMI, FL, 33136

Secretary

Name Role Address
Feinberg Fran Secretary 1265 NW 12TH AVE, MIAMI, FL, 331362140

Treasurer

Name Role Address
Stefanova Lidija Treasurer 1265 NW 12 Avenue, Miami, FL, 33136

Chief Financial Officer

Name Role Address
Chen Yvonne Chief Financial Officer 1265 NW 12TH AVE, MIAMI, FL, 33136

Related by officers

Potamkin Alan

PLACE ST. MICHEL, INC.

Related by address

No related companies by address

Date of last update: 02 Jan 2025

Sources: Florida Department of State

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