| Entity Name: | COLLIER CHIROPRACTIC AND ACCIDENT REHABILITATION CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 30 Jun 2003 (22 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 23 Feb 2022 (3 years ago) |
| Document Number: | P03000072461 |
| FEI/EIN Number | 450522723 |
| Address: | 2180 IMMOKALEE RD., SUITE 201, NAPLES, FL, 34110, US |
| Mail Address: | 2180 IMMOKALEE RD, SUITE 201, NAPLES, FL, 34110, US |
| ZIP code: | 34110 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174741581 | 2007-04-23 | 2015-03-10 | 2180 IMMOKALEE RD, SUITE 201, NAPLES, FL, 341101421, US | 2180 IMMOKALEE RD, SUITE 201, NAPLES, FL, 341101421, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 239-594-8995 |
| Fax | 2395949976 |
Authorized person
| Name | DR. RICHARD MAIR |
| Role | CHIROPRACTIC PHYSICIAN |
| Phone | 2395948995 |
Taxonomy
| Taxonomy Code | 111NR0400X - Rehabilitation Chiropractor |
| License Number | CH0006936 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 111NR0400X - Rehabilitation Chiropractor |
| License Number | CH0008293 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 55472 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COLLIER CHIROPRACTIC AND ACCIDENT REHABILITATION CENTER INC 401K PROFIT SHARING PLAN | 2023 | 450522723 | 2024-10-06 | COLLIER CHIROPRACTIC AND ACCIDENT REHABILITATION CENTER, INC. | 3 | |||||||||||||
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| CCAARC CASH BALANCE PLAN | 2019 | 450522723 | 2020-10-13 | COLLIER CHIROPRACTIC AND ACCIDENT REHABILITATION CENTER, INC | 4 | |||||||||||||
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| CCAARC CASH BALANCE PLAN | 2016 | 450522723 | 2018-01-29 | COLLIER CHIROPRACTIC AND ACCIDENT REHABILITATION CENTER, INC. | 3 | |||||||||||||
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| Name | Role | Address |
|---|---|---|
| FRICK BRADLEY D.C. | Agent | 2180 IMMOKALEE ROAD - STE. 201, NAPLES, FL, 34110 |
| Name | Role | Address |
|---|---|---|
| FRICK BRADLEY D.C. | President | 2180 IMMOKALEE ROAD - STE. 201, NAPLES, FL, 34110 |
| Name | Role | Address |
|---|---|---|
| KITCHEN LINDA J | Chief Financial Officer | 2180 IMMOKALEE ROAD - STE. 201, NAPLES, FL, 34110 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2022-02-23 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-02-23 | FRICK, BRADLEY, D.C. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-02-23 | 2180 IMMOKALEE ROAD - STE. 201, NAPLES, FL 34110 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-01-16 | 2180 IMMOKALEE RD., SUITE 201, NAPLES, FL 34110 | No data |
| CHANGE OF MAILING ADDRESS | 2015-01-16 | 2180 IMMOKALEE RD., SUITE 201, NAPLES, FL 34110 | No data |
| AMENDMENT | 2009-02-05 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-10 |
| ANNUAL REPORT | 2023-01-20 |
| Amendment | 2022-02-23 |
| ANNUAL REPORT | 2022-02-04 |
| ANNUAL REPORT | 2021-02-07 |
| ANNUAL REPORT | 2020-02-05 |
| ANNUAL REPORT | 2019-02-06 |
| ANNUAL REPORT | 2018-01-11 |
| ANNUAL REPORT | 2017-01-16 |
| ANNUAL REPORT | 2016-02-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
