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  5. ALZHEIMER'S COMMUNITY CARE, INC.

ALZHEIMER'S COMMUNITY CARE, INC.

Company Details

Entity Name: ALZHEIMER'S COMMUNITY CARE, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active
Date Filed: 08 Oct 1996 (28 years ago)
Document Number: N96000005197
FEI/EIN Number 311481653
Address: 800 NORTHPOINT PARKWAY, SUITE 101-B, WEST PALM BEACH, FL, 33407
Mail Address: 800 NORTHPOINT PARKWAY, SUITE 101-B, WEST PALM BEACH, FL, 33407
ZIP code: 33407
County: Palm Beach
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1285998096 2012-06-26 2023-03-01 800 NORTHPOINT PKWY, SUITE 101B, WEST PALM BEACH, FL, 334071978, US 800 NORTHPOINT PKWY, SUITE 101B, WEST PALM BEACH, FL, 334071978, US

Contacts
Phone +1 561-683-2700
Fax 5616837600

Authorized person
Name MICHAEL JESSUP
Role PRESIDENT AND CEO
Phone 5616832700

Taxonomy
Taxonomy Code 251B00000X - Case Management Agency
Is Primary No
Taxonomy Code 261QA0600X - Adult Day Care Clinic/Center
Is Primary Yes
Taxonomy Code 311500000X - Alzheimer Center (Dementia Center)
Is Primary No
Taxonomy Code 385H00000X - Respite Care
Is Primary No

Other Provider Identifiers
Issuer MEDICAID
Number 67
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ALZHEIMER'S COMMUNITY CARE 401(K) PLAN 2019 311481653 2021-01-14 ALZHEIMER'S COMMUNITY CARE, INC. 84
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 624200
Sponsor’s telephone number 5616832700
Plan sponsor’s address 800 NORTHPOINT PARKWAY, SUITE 101-B, WEST PALM BEACH, FL, 33407

Signature of
Role Plan administrator
Date 2021-01-14
Name of individual signing MARY M. BARNES
Valid signature Filed with authorized/valid electronic signature
ALZHEIMER'S COMMUNITY CARE 401(K) PLAN 2018 311481653 2020-03-04 ALZHEIMER'S COMMUNITY CARE, INC. 65
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 624200
Sponsor’s telephone number 5616832700
Plan sponsor’s address 800 NORTHPOINT PARKWAY, SUITE 101-B, WEST PALM BEACH, FL, 33407

Signature of
Role Plan administrator
Date 2020-03-04
Name of individual signing MARY BARNES
Valid signature Filed with authorized/valid electronic signature
ALZHEIMERS COMMUNITY CARE 401(K) RETIREMENT SAVINGS PLAN 2017 311481653 2019-04-12 ALZHEIMER'S COMMUNITY CARE, INC. 62
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 624200
Sponsor’s telephone number 5616832700
Plan sponsor’s address 800 NORTHPOINT PARKWAY, SUITE 101-B, WEST PALM BEACH, FL, 33407
ALZHEIMER'S COMMUNITY CARE 401(K) RETIREMENT SAVINGS PLAN 2016 311481653 2018-04-13 ALZHEIMER'S COMMUNITY CARE, INC. 77
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 624200
Sponsor’s telephone number 5616832700
Plan sponsor’s address 800 NORTHPOINT PARKWAY, SUITE 101-B, WEST PALM BEACH, FL, 33407
ALZHEIMER'S COMMUNITY CARE 401(K) RETIREMENT SAVINGS PLAN 2015 311481653 2017-01-24 ALZHEIMER'S COMMUNITY CARE, INC. 70
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 624200
Sponsor’s telephone number 5616832700
Plan sponsor’s address 800 NORTHPOINT PARKWAY, SUITE 101-B, WEST PALM BEACH, FL, 33407
ALZHEIMER'S COMMUNITY CARE 401(K) RETIREMENT SAVINGS PLAN 2014 311481653 2016-03-17 ALZHEIMER'S COMMUNITY CARE, INC. 99
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 624200
Sponsor’s telephone number 5616832700
Plan sponsor’s address 800 NORTHPOINT PARKWAY, SUITE 101-B, WEST PALM BEACH, FL, 33407
ALZHEIMER'S COMMUNITY CARE 401(K) RETIREMENT SAVINGS PLAN 2013 311481653 2015-01-29 ALZHEIMER'S COMMUNITY CARE, INC. 75
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 624200
Sponsor’s telephone number 5616832700
Plan sponsor’s address 800 NORTHPOINT PARKWAY, SUITE 101-B, WEST PALM BEACH, FL, 33407

Signature of
Role Plan administrator
Date 2015-01-29
Name of individual signing MARY M. BARNES
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
JONES FOSTER SERVICE, LLC Agent

Director

Name Role Address
Franklin David S Director 800 NORTHPOINT PARKWAY, WEST PALM BEACH, FL, 33407
JOHNSON RANDY K Director 1900 W. 23RD STREET, RIVIERA BEACH, FL, 33404

Immi

Name Role Address
Gorman Robert Immi 3300 Twin Lakes Terrace, Fort Pierce, FL, 34951

Chairman

Name Role Address
Shalloway G. Mark Chairman 1400 Centrepark Blvd., West Palm Beach, FL, 33401

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G19000076536 BOCA RATON BRAIN BOWL EXPIRED 2019-07-15 2024-12-31 No data 800 NORTH POINT PKWY, 101-B, WEST PALM BEACH, FL, 33407

Events

Event Type Filed Date Value Description
NAME CHANGE AMENDMENT 2001-12-10 ALZHEIMER'S COMMUNITY CARE, INC. No data

Court Cases

Title Case Number Docket Date Status
ALZHEIMER'S COMMUNITY CARE, INC. VS SUSI TIEKERT 4D2023-0136 2023-01-12 Closed
Classification Original Proceedings - Circuit Civil - Certiorari
Court 4th District Court of Appeal
Originating Court Circuit Court for the Fifteenth Judicial Circuit, Palm Beach County
502022CA005870

Parties
Name ALZHEIMER'S COMMUNITY CARE, INC.
Role Petitioner
Status Active
Representations Matthew J Shilling, Hinda Klein
Name Susi Tiekert
Role Respondent
Status Active
Representations Joshua Molandes
Name Hon. Paige Hardy Gillman
Role Judge/Judicial Officer
Status Active
Name Clerk - Palm Beach
Role Lower Tribunal Clerk
Status Active

Docket Entries
Docket Date 2023-01-12
Type Misc. Events
Subtype Case Filing Fee Paid through Portal
Description Case Filing Fee Paid Through Portal
Docket Date 2023-01-12
Type Letter
Subtype Acknowledgment Letter
Description Writ of Certiorari / Acknowledgment letter
Docket Date 2023-01-12
Type Record
Subtype Appendix to Petition
Description Appendix to Petition
Docket Date 2023-01-12
Type Petition
Subtype Petition Certiorari
Description Petition for Certiorari Filed ~ Filing Fee Paid Through Portal
On Behalf Of Alzheimer's Community Care, Inc.
Docket Date 2023-01-30
Type Disposition
Subtype Denied
Description Denied - Order by Judge
Docket Date 2023-01-30
Type Disposition by Order
Subtype Denied
Description Order Denying Petition for Writ - Certiorari ~ ORDERED that the January 12, 2023 petition for writ of certiorari is denied.KLINGENSMITH, C.J., WARNER and DAMOORGIAN, JJ., concur.

Related by officers

Franklin David S

ALZHEIMER'S COMMUNITY CARE FOUNDATION, INC.

Gorman Robert

LEGAL AID SOCIETY OF THE BAR ASSOCIATIONS OF ST. LUCIE COUNTY, INC. SYNERGETICS, INC. OF MISSOURI

JOHNSON RANDY K

KIWANIS CLUB OF WESTSIDE, WEST PALM BEACH SCHOLARSHIP FUND, 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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