| Entity Name: | COASTAL BEHAVIORAL THERAPY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 22 Feb 2002 (23 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 11 May 2007 (18 years ago) |
| Document Number: | P02000020986 |
| FEI/EIN Number | 753007743 |
| Address: | 590 SOLUTIONS WAY, SUITE 120, ROCKLEDGE, FL, 32955, US |
| Mail Address: | 590 SOLUTIONS WAY, SUITE 120, ROCKLEDGE, FL, 32955, US |
| ZIP code: | 32955 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558492090 | 2007-03-08 | 2024-09-25 | 590 SOLUTIONS WAY STE 120, ROCKLEDGE, FL, 329553623, US | 590 SOLUTIONS WAY STE 120, ROCKLEDGE, FL, 329553623, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 321-684-3334 |
| Fax | 3216359171 |
| Phone | +1 321-635-9535 |
Authorized person
| Name | MR. ISIDRO ZAVALETA |
| Role | EXECUTIVE DIRECTOR |
| Phone | 3216843334 |
Taxonomy
| Taxonomy Code | 101Y00000X - Counselor |
| Is Primary | No |
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | No |
| Taxonomy Code | 106E00000X - Assistant Behavior Analyst |
| Is Primary | No |
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COASTAL BEHAVIORAL THERAPY, INC. SAFE HARBOR 401K PROFIT SHARING PLAN | 2015 | 753007743 | 2016-07-22 | COASTAL BEHAVIORAL THERAPY, INC. | 4 | |||||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2016-07-22 |
| Name of individual signing | ISIDRO ZAVALETA |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2016-07-22 |
| Name of individual signing | ISIDRO ZAVALETA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2013-01-01 |
| Business code | 621112 |
| Sponsor’s telephone number | 3216359535 |
| Plan sponsor’s address | 590 SOLUTIONS WAY, SUITE 120, ROCKLEDGE, FL, 32955 |
Signature of
| Role | Plan administrator |
| Date | 2016-07-20 |
| Name of individual signing | ISIDRO ZAVALETA |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2016-07-20 |
| Name of individual signing | ISIDRO ZAVALETA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2013-01-01 |
| Business code | 621112 |
| Sponsor’s telephone number | 3216359535 |
| Plan sponsor’s address | 590 SOLUTIONS WAY, SUITE 120, ROCKLEDGE, FL, 32955 |
Signature of
| Role | Plan administrator |
| Date | 2015-07-27 |
| Name of individual signing | ISIDRO ZAVALETA |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2015-07-27 |
| Name of individual signing | ISIDRO ZAVALETA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2013-01-01 |
| Business code | 621112 |
| Sponsor’s telephone number | 3216359535 |
| Plan sponsor’s address | 590 SOLUTIONS WAY, SUITE 120, ROCKLEDGE, FL, 32955 |
Signature of
| Role | Plan administrator |
| Date | 2014-09-29 |
| Name of individual signing | ISIDRO ZAVALETA |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2014-09-29 |
| Name of individual signing | ISIDRO ZAVALETA |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| ZAVALETA ISIDRO J | Agent | 590 SOLUTIONS WAY, ROCKLEDGE, FL, 32955 |
| Name | Role | Address |
|---|---|---|
| ZAVALETA ISIDRO J | President | 590 Solutions Way, STE 120, ROCKLEDGE, FL, 32955 |
| Name | Role | Address |
|---|---|---|
| ZAVALETA ISIDRO J | Treasurer | 590 Solutions Way, STE 120, ROCKLEDGE, FL, 32955 |
| Name | Role | Address |
|---|---|---|
| ZAVALETA ISIDRO J | Secretary | 590 Solutions Way, STE 120, ROCKLEDGE, FL, 32955 |
| Name | Role | Address |
|---|---|---|
| ZAVALETA REBECCA L | Vice President | 590 Solutions Way, STE 120, ROCKLEDGE, FL, 32955 |
| Name | Role | Address |
|---|---|---|
| ZAVALETA REBECCA L | Director | 590 Solutions Way, STE 120, ROCKLEDGE, FL, 32955 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2009-03-11 | 590 SOLUTIONS WAY, SUITE 120, ROCKLEDGE, FL 32955 | No data |
| CHANGE OF MAILING ADDRESS | 2009-03-11 | 590 SOLUTIONS WAY, SUITE 120, ROCKLEDGE, FL 32955 | No data |
| REGISTERED AGENT NAME CHANGED | 2009-03-11 | ZAVALETA, ISIDRO J | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-03-11 | 590 SOLUTIONS WAY, SUITE 120, ROCKLEDGE, FL 32955 | No data |
| AMENDMENT | 2007-05-11 | No data | No data |
| AMENDMENT | 2007-04-11 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-07 |
| ANNUAL REPORT | 2023-04-03 |
| ANNUAL REPORT | 2022-03-09 |
| ANNUAL REPORT | 2021-04-02 |
| ANNUAL REPORT | 2020-04-06 |
| ANNUAL REPORT | 2019-04-02 |
| ANNUAL REPORT | 2018-03-28 |
| ANNUAL REPORT | 2017-04-14 |
| ANNUAL REPORT | 2016-03-28 |
| ANNUAL REPORT | 2015-03-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
