| Entity Name: | BRACKEN CHIROPRACTIC HEALTH CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 06 Oct 2006 (18 years ago) |
| Date of dissolution: | 24 Sep 2010 (14 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2010 (14 years ago) |
| Document Number: | P06000128066 |
| FEI/EIN Number | 202186093 |
| Address: | 955 CANDLELIGHT BOULEVARD, BROOKSVILLE, FL, 34601 |
| Mail Address: | 955 CANDLELIGHT BOULEVARD, BROOKSVILLE, FL, 34601 |
| ZIP code: | 34601 |
| County: | Hernando |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1871778092 | 2008-01-07 | 2008-05-07 | 955 CANDLELIGHT BLVD, BROOKSVILLE, FL, 346013119, US | 955 CANDLELIGHT BLVD, BROOKSVILLE, FL, 346013119, US | |||||||||||||||||||||||
|
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| Phone | +1 352-799-1977 |
Authorized person
| Name | THOMAS P BRACKEN |
| Role | OWNER |
| Phone | 3527997977 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH0006282 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 381630300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| THOMAS BRACKEN P | Agent | 955 CANDLELIGHT BOULEVARD, BROOKSVILLE, FL, 34601 |
| Name | Role | Address |
|---|---|---|
| BRACKEN THOMAS P | President | 9372 SUGAR COURT, WEEKI WACHEE, FL, 34613 |
| Name | Role | Address |
|---|---|---|
| BRACKEN THOMAS P | Vice President | 9372 SUGAR COURT, WEEKI WACHEE, FL, 34613 |
| Name | Role | Address |
|---|---|---|
| BRACKEN THOMAS P | Secretary | 9372 SUGAR COURT, WEEKI WACHEE, FL, 34613 |
| Name | Role | Address |
|---|---|---|
| BRACKEN THOMAS P | Treasurer | 9372 SUGAR COURT, WEEKI WACHEE, FL, 34613 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2007-07-10 | THOMAS, BRACKEN P | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2007-07-10 | 955 CANDLELIGHT BOULEVARD, BROOKSVILLE, FL 34601 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2009-04-21 |
| ANNUAL REPORT | 2008-04-24 |
| ANNUAL REPORT | 2007-07-10 |
| Domestic Profit | 2006-10-06 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
