| Entity Name: | PHYLLIS DUNCOMBE CHILDCARE AND FAMILY RESOURCE CENTER, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 15 Nov 2004 (20 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | P04000155318 |
| FEI/EIN Number | 251909048 |
| Address: | 11820 49TH STREET NORTH, WEST PALM BEACH, FL, 33411 |
| Mail Address: | 11820 49TH STREET NORTH, WEST PALM BEACH, FL, 33411 |
| ZIP code: | 33411 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962710152 | 2010-09-22 | 2010-09-22 | 11820 49TH ST N, WEST PALM BEACH, FL, 334119159, US | 11820 49TH ST N, WEST PALM BEACH, FL, 334119159, US | |||||||||||||||||||||||||
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| Phone | +1 561-784-8540 |
| Fax | 5617848540 |
Authorized person
| Name | MR. DONALD CECIL DUNCOMBE |
| Role | DIRECTOR |
| Phone | 5617848540 |
Taxonomy
| Taxonomy Code | 320900000X - Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| License Number | 091149 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID AGED AND DISABLED ADULT WAIVER PROVIDER |
| Number | 692654196 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DUNCOMBE DONALD C | Agent | 11820 49TH STREET NORTH, WEST PALM BEACH, FL, 33411 |
| Name | Role | Address |
|---|---|---|
| DUNCOMBE PHYLLIS M | President | 11820 49TH STREET, WEST PALM BEACH, FL, 33411 |
| Name | Role | Address |
|---|---|---|
| DUNCOMBE DONALD C | Director | 11820 49TH STREET NORTH, WEST PALM BEACH, FL, 33411 |
| Name | Role | Address |
|---|---|---|
| DUNCOMBE KIMBERLY | Vice President | 231 W. 23RD ST, RIVIERA BEACH, FL, 33414 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000013155 | ADULT ALLIANCE GROUP HOME | EXPIRED | 2015-02-05 | 2020-12-31 | No data | 11820 49TH ST. N., WEST PALM BEACH, FL, 33411 |
| G08007900054 | ADULT ALLIANCE AND RESOURCE CENTER | EXPIRED | 2008-01-04 | 2013-12-31 | No data | 11820 49TH STREET NORTH, WEST PALM BEACH, FL, 33411 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2007-07-09 | 11820 49TH STREET NORTH, WEST PALM BEACH, FL 33411 | No data |
| CHANGE OF MAILING ADDRESS | 2007-07-09 | 11820 49TH STREET NORTH, WEST PALM BEACH, FL 33411 | No data |
| REGISTERED AGENT NAME CHANGED | 2007-07-09 | DUNCOMBE, DONALD CD | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2007-07-09 | 11820 49TH STREET NORTH, WEST PALM BEACH, FL 33411 | No data |
| NAME CHANGE AMENDMENT | 2005-01-24 | PHYLLIS DUNCOMBE CHILDCARE AND FAMILY RESOURCE CENTER, INC | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J13001581447 | TERMINATED | 1000000531976 | PALM BEACH | 2013-10-02 | 2033-10-29 | $ 330.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, WEST PALM BEACH SERVICE CENTER, 2468 METROCENTRE BLVD, WEST PALM BEACH FL334073105 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-03-02 |
| ANNUAL REPORT | 2016-01-28 |
| ANNUAL REPORT | 2015-02-05 |
| ANNUAL REPORT | 2014-01-27 |
| ANNUAL REPORT | 2013-02-14 |
| ANNUAL REPORT | 2012-02-28 |
| ANNUAL REPORT | 2011-04-23 |
| ANNUAL REPORT | 2010-04-09 |
| ANNUAL REPORT | 2009-04-30 |
| ANNUAL REPORT | 2008-01-04 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
