| Entity Name: | CORNERSTONE PSYCHIATRIC SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
CORNERSTONE PSYCHIATRIC SERVICES, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| 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: | 14 Jan 2003 (22 years ago) |
| Document Number: | P03000006846 |
| FEI/EIN Number |
481295471
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1790 E VENICE AVE, SUITE 204, VENICE, FL, 34292, UN |
| Mail Address: | 1790 E VENICE AVE, SUITE 204, VENICE, FL, 34292, UN |
| ZIP code: | 34292 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1932195187 | 2005-09-23 | 2022-09-22 | 1790 E VENICE AVE, SUITE 204, VENICE, FL, 342923191, US | 1790 E VENICE AVE, SUITE 204, VENICE, FL, 342923191, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 941-488-8884 |
| Fax | 9414885554 |
Authorized person
| Name | BRAD LABATH |
| Role | OFFICE MANAGER |
| Phone | 9414888884 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | OS8175 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| License Number | ARNP1799382 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 270064600 |
| State | FL |
| Issuer | AETNA |
| Number | 7384438 |
| State | FL |
| Issuer | RAILROAD MEDICARE |
| Number | DA7120 |
| State | FL |
| Issuer | MAGELLAN |
| Number | 557401-000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Donahue David | Director | 6232 Winding Pine Drive, Nokomis, FL, 34275 |
| FAWKS DAVID R | Treasurer | 5376 DOMINICA CIR, SARASOTA, FL, 34233 |
| FAWKS DAVID R | Director | 5376 DOMINICA CIR, SARASOTA, FL, 34233 |
| WALTERS JOEL WESQUIRE | Agent | 1819 MAIN STREET - SUITE 1110, SARASOTA, FL, 34236 |
| Donahue David | President | 6232 Winding Pine Drive, Nokomis, FL, 34275 |
| FAWKS DAVID R | Secretary | 5376 DOMINICA CIR, SARASOTA, FL, 34233 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2016-07-25 | WALTERS, JOEL W, ESQUIRE | - |
| REGISTERED AGENT ADDRESS CHANGED | 2009-11-19 | 1819 MAIN STREET - SUITE 1110, SARASOTA, FL 34236 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2009-03-09 | 1790 E VENICE AVE, SUITE 204, VENICE, FL 34292 UN | - |
| CHANGE OF MAILING ADDRESS | 2009-03-09 | 1790 E VENICE AVE, SUITE 204, VENICE, FL 34292 UN | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-12 |
| ANNUAL REPORT | 2023-02-22 |
| ANNUAL REPORT | 2022-03-03 |
| ANNUAL REPORT | 2021-02-23 |
| ANNUAL REPORT | 2020-03-09 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-02-16 |
| ANNUAL REPORT | 2017-01-17 |
| Reg. Agent Change | 2016-07-25 |
| ANNUAL REPORT | 2016-03-28 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 6334157709 | 2020-05-01 | 0455 | PPP | 1790 E VENICE AVE STE 204, VENICE, FL, 34292-3191 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Mar 2025
Sources: Florida Department of State
