| Entity Name: | BREVARD ALZHEIMER'S FOUNDATION, 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: | 11 Dec 1995 (29 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 16 Apr 1996 (29 years ago) |
| Document Number: | N95000005824 |
| FEI/EIN Number |
593369526
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4676 N WICKHAM RD, MELBOURNE, FL, 32935-7103, US |
| Mail Address: | 4676 N WICKHAM RD, MELBOURNE, FL, 32935-7103, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518633569 | 2021-08-19 | 2021-08-19 | 4676 N WICKHAM RD, MELBOURNE, FL, 329357103, US | 830 S PARK AVE, TITUSVILLE, FL, 327804000, US | |||||||||||||||||||||
|
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| Phone | +1 321-253-4430 |
| Fax | 3212531993 |
Authorized person
| Name | TIMOTHY VICTOR TIMMEMANN |
| Role | EXECUTIVE DIRECTOR |
| Phone | 3212534430 |
Taxonomy
| Taxonomy Code | 261QA0600X - Adult Day Care Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 104835401 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Rooks Janet | Chairman | 4676 N WICKHAM RD, MELBOURNE, FL, 32935 |
| Robinson Shane | Director | 4676 N WICKHAM RD, MELBOURNE, FL, 32935 |
| Molitor Scott | Treasurer | 4676 N WICKHAM RD, MELBOURNE, FL, 32935 |
| Lewis Richard J | Director | 4676 N WICKHAM RD, MELBOURNE, FL, 329357103 |
| Clevens Ross Dr. | Director | 4676 N WICKHAM RD, MELBOURNE, FL, 329357103 |
| Rhodes Ruth Esq. | Director | 4676 N WICKHAM RD, MELBOURNE, FL, 329357103 |
| Sell Russell | Agent | 4676 N. WICKHAM ROAD, MELBOURNE, FL, 32935 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000105713 | SAFE-RIDE | EXPIRED | 2012-10-31 | 2017-12-31 | - | 4676 N. WICKHAM ROAD, MELBOURNE, FL, 32935 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-02-13 | Sell, Russell | - |
| REGISTERED AGENT ADDRESS CHANGED | 2012-09-13 | 4676 N. WICKHAM ROAD, MELBOURNE, FL 32935 | - |
| CHANGE OF PRINCIPAL ADDRESS | 1999-05-06 | 4676 N WICKHAM RD, MELBOURNE, FL 32935-7103 | - |
| CHANGE OF MAILING ADDRESS | 1999-05-06 | 4676 N WICKHAM RD, MELBOURNE, FL 32935-7103 | - |
| AMENDMENT | 1996-04-16 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-21 |
| ANNUAL REPORT | 2024-02-13 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-02-01 |
| ANNUAL REPORT | 2021-01-18 |
| ANNUAL REPORT | 2020-01-17 |
| AMENDED ANNUAL REPORT | 2019-05-23 |
| ANNUAL REPORT | 2019-04-01 |
| ANNUAL REPORT | 2018-03-30 |
| ANNUAL REPORT | 2017-04-12 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
