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  5. THE HOUSE OF ISRAEL, INC.

THE HOUSE OF ISRAEL, INC.

Company Details

Entity Name: THE HOUSE OF ISRAEL, INC.
Jurisdiction: FLORIDA
Filing Type: Florida Not For Profit Corporation
Status: Active
Date Filed: 08 Aug 1997 (27 years ago)
Last Event: AMENDMENT
Event Date Filed: 06 Jan 2023 (2 years ago)
Document Number: N97000004510
FEI/EIN Number 59-3464296
Address: 4 SW 5TH STREET, FT MEADE, FL 33841
Mail Address: PO BOX 881, FT MEADE, FL 33841
ZIP code: 33841
County: Polk
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1477125516 2021-07-16 2021-09-28 PO BOX 881, FORT MEADE, FL, 338410881, US 4 5TH ST SW, FORT MEADE, FL, 338413410, US

Contacts
Phone +1 863-712-2774
Fax 8886778750

Authorized person
Name MRS. MAURICE CAMPBELL
Role DIRECTOR
Phone 8637122774

Taxonomy
Taxonomy Code 101YA0400X - Addiction (Substance Use Disorder) Counselor
Is Primary No
Taxonomy Code 104100000X - Social Worker
Is Primary No
Taxonomy Code 177F00000X - Lodging Provider
Is Primary No
Taxonomy Code 251B00000X - Case Management Agency
Is Primary No
Taxonomy Code 251S00000X - Community/Behavioral Health Agency
Is Primary Yes
Taxonomy Code 251V00000X - Voluntary or Charitable Agency
Is Primary No
Taxonomy Code 261QE0002X - Emergency Care Clinic/Center
Is Primary No
Taxonomy Code 261QM0850X - Adult Mental Health Clinic/Center
Is Primary No
Taxonomy Code 324500000X - Substance Abuse Rehabilitation Facility
Is Primary No

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
THE HOUSE OF ISRAEL INC. 401(K) PLAN 2019 593464296 2021-01-05 THE HOUSE OF ISRAEL INC. 1
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-12-01
Business code 624200
Sponsor’s telephone number 8637122774
Plan sponsor’s address 4 SW 5TH STREET, FORT MEADE, FL, 33841

Signature of
Role Plan administrator
Date 2021-01-05
Name of individual signing MAURICE CAMPBELL
Valid signature Filed with authorized/valid electronic signature
THE HOUSE OF ISRAEL INC. 401(K) PLAN 2018 593464296 2020-12-28 THE HOUSE OF ISRAEL INC. 1
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-12-01
Business code 624200
Sponsor’s telephone number 8632856632
Plan sponsor’s address 4 SW 5TH STREET, FORT MEADE, FL, 33841

Signature of
Role Plan administrator
Date 2020-12-28
Name of individual signing MAURICE NELSON
Valid signature Filed with authorized/valid electronic signature
THE HOUSE OF ISRAEL INC. 401(K) PLAN 2017 593464296 2018-11-30 THE HOUSE OF ISRAEL INC. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-12-01
Business code 624200
Sponsor’s telephone number 8632856632
Plan sponsor’s address 4 SW 5TH STREET, FORT MEADE, FL, 33841

Signature of
Role Plan administrator
Date 2018-11-30
Name of individual signing MAURICE NELSON
Valid signature Filed with authorized/valid electronic signature
THE HOUSE OF ISRAEL INC. 401(K) PLAN 2017 593464296 2018-11-29 THE HOUSE OF ISRAEL INC. 3
Three-digit plan number (PN) 002
Effective date of plan 2016-12-01
Business code 624200
Sponsor’s telephone number 8632856632
Plan sponsor’s address 4 SW 5TH STREET, FORT MEADE, FL, 33841

Signature of
Role Plan administrator
Date 2018-11-29
Name of individual signing MAURICE NELSON
Valid signature Filed with authorized/valid electronic signature
THE HOUSE OF ISRAEL INC. 401(K) PLAN 2016 593464296 2017-11-08 THE HOUSE OF ISRAEL INC. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-12-01
Business code 624200
Sponsor’s telephone number 8632856632
Plan sponsor’s address 4 SW 5TH STREET, FORT MEADE, FL, 33841

Signature of
Role Plan administrator
Date 2017-11-08
Name of individual signing MAURICE NELSON
Valid signature Filed with authorized/valid electronic signature
THE HOUSE OF ISRAEL INC. 401(K) PLAN 2016 593464296 2017-11-06 THE HOUSE OF ISRAEL INC. 3
Three-digit plan number (PN) 002
Effective date of plan 2016-12-01
Sponsor’s telephone number 8632856632
Plan sponsor’s address 4 SW 5TH STREET, FORT MEADE, FL, 33841

Signature of
Role Plan administrator
Date 2017-11-06
Name of individual signing MAURICE NELSON
Valid signature Filed with authorized/valid electronic signature
THE HOUSE OF ISRAEL, INC. 403(B) PLAN 2015 593464296 2016-10-10 THE HOUSE OF ISRAEL, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 624200
Sponsor’s telephone number 8632856632
Plan sponsor’s address 4 SW 5TH ST, FT. MEADE, FL, 33841

Signature of
Role Plan administrator
Date 2016-10-10
Name of individual signing MAURICE NELSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-10-10
Name of individual signing MAURICE NELSON
Valid signature Filed with authorized/valid electronic signature
THE HOUSE OF ISRAEL, INC. 403(B) PLAN 2014 593464296 2015-10-15 THE HOUSE OF ISRAEL, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 624200
Sponsor’s telephone number 8632856632
Plan sponsor’s address 4 SW 5TH ST, FT. MEADE, FL, 33841

Signature of
Role Plan administrator
Date 2015-10-15
Name of individual signing SANDRA R. TURNER, ERPA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-10-15
Name of individual signing SANDRA R. TURNER, ERPA
Valid signature Filed with authorized/valid electronic signature
THE HOUSE OF ISRAEL, INC. 403(B) PLAN 2013 593464296 2014-10-13 THE HOUSE OF ISRAEL, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 624200
Sponsor’s telephone number 8632856632
Plan sponsor’s address 4 SW 5TH ST, FT. MEADE, FL, 33841

Signature of
Role Plan administrator
Date 2014-10-12
Name of individual signing MAURICE NELSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-10-12
Name of individual signing MAURICE NELSON
Valid signature Filed with authorized/valid electronic signature
THE HOUSE OF ISRAEL, INC. 403(B) PLAN 2012 593464296 2013-06-18 THE HOUSE OF ISRAEL, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 624200
Sponsor’s telephone number 8632856632
Plan sponsor’s address 4 SW 5TH ST, FT. MEADE, FL, 33841

Signature of
Role Plan administrator
Date 2013-06-18
Name of individual signing MAURICE NELSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-06-18
Name of individual signing MAURICE NELSON
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
CAMPBELL, MAURICE Agent 103 S E 7TH STREET, FT MEADE, FL 33841

Treasurer

Name Role Address
CAMPBELL, MAURICE Treasurer PO BOX 881, FT MEADE, FL 33841

Secretary

Name Role Address
NELSON, WANDA Secretary 5752 WOODRUFF WAY, LAKELAND, FL 33812

Vice President

Name Role Address
CLARK, JENNIFER Vice President 1025 MORNING STAR DR., LAKELAND, FL 33810

President

Name Role Address
CORNELIUS, CLINTON President PO BOX 736, FT MEADE, FL 33841

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G24000031644 C & G COMMUNITY DEVELOPMENT CORPORATION ACTIVE 2024-02-29 2029-12-31 No data P O BOX 881, FORT MEADE, FL, 33841
G18000057149 THE HOUSE OF ISRAEL COMMUNITY DEVELOPMENT CORPORATION ACTIVE 2018-05-09 2028-12-31 No data P O BOX 881, FORT MEADE, FL, 33841

Events

Event Type Filed Date Value Description
AMENDMENT 2023-01-06 No data No data
AMENDMENT 2020-04-08 No data No data
REGISTERED AGENT NAME CHANGED 2018-04-27 CAMPBELL, MAURICE No data
CHANGE OF PRINCIPAL ADDRESS 2012-04-06 4 SW 5TH STREET, FT MEADE, FL 33841 No data
REGISTERED AGENT ADDRESS CHANGED 2006-02-28 103 S E 7TH STREET, FT MEADE, FL 33841 No data
AMENDMENT 2002-02-28 No data No data
CHANGE OF MAILING ADDRESS 2001-03-06 4 SW 5TH STREET, FT MEADE, FL 33841 No data
AMENDMENT 1998-05-15 No data No data
AMENDMENT 1998-02-04 No data No data

Documents

Name Date
ANNUAL REPORT 2025-01-29
ANNUAL REPORT 2024-02-06
ANNUAL REPORT 2023-01-25
Amendment 2023-01-06
ANNUAL REPORT 2022-03-10
ANNUAL REPORT 2021-02-01
ANNUAL REPORT 2020-04-17
Amendment 2020-04-08
ANNUAL REPORT 2019-02-13
ANNUAL REPORT 2018-04-27

Related by officers

CORNELIUS, CLINTON

CONCERNED CITIZENS OF THE WESTERN COMMUNITIES, INC.

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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