| Entity Name: | CHANGES YOUTH & FAMILY SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 16 Apr 2008 (17 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | P08000038558 |
| FEI/EIN Number | 262452464 |
| Address: | 3270 SUNTREE BLVD., SUITE 101, MELBOURNE, FL, 32940 |
| Mail Address: | 3270 SUNTREE BLVD., SUITE 101, MELBOURNE, FL, 32940 |
| ZIP code: | 32940 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255584033 | 2008-10-24 | 2008-10-24 | 3270 SUNTREE BLVD, SUITE 127, MELBOURNE, FL, 329407530, US | 3270 SUNTREE BLVD, SUITE 127, MELBOURNE, FL, 329407530, US | |||||||||||||||||||||||
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| Phone | +1 321-610-7949 |
| Fax | 3216107947 |
Authorized person
| Name | MRS. KWANYA SANDERS |
| Role | EXECUTIVE DIRECTOR |
| Phone | 3216107949 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 076875800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SANDERS KWANYA M | Agent | 3270 SUNTREE BLVD., MELBOURNE, FL, 32940 |
| Name | Role | Address |
|---|---|---|
| SANDERS KWANYA M | Director | 3270 SUNTREE BLVD, SUITE 101, MELBOURNE, FL, 32940 |
| JACKSON VALERIE P | Director | 3270 SUNTREE BLVD, SUITE 101, MELBOURNE, FL, 32940 |
| Name | Role | Address |
|---|---|---|
| SANDERS KWANYA M | President | 3270 SUNTREE BLVD, SUITE 101, MELBOURNE, FL, 32940 |
| JACKSON VALERIE P | President | 3270 SUNTREE BLVD, SUITE 101, MELBOURNE, FL, 32940 |
| Name | Role | Address |
|---|---|---|
| SANDERS KWANYA M | Secretary | 3270 SUNTREE BLVD, SUITE 101, MELBOURNE, FL, 32940 |
| Name | Role | Address |
|---|---|---|
| JACKSON VALERIE P | Vice President | 3270 SUNTREE BLVD, SUITE 101, MELBOURNE, FL, 32940 |
| Name | Role | Address |
|---|---|---|
| JACKSON VALERIE P | Treasurer | 3270 SUNTREE BLVD, SUITE 101, MELBOURNE, FL, 32940 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-01-11 | 3270 SUNTREE BLVD., SUITE 101, MELBOURNE, FL 32940 | No data |
| REINSTATEMENT | 2011-03-01 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-03-01 | 3270 SUNTREE BLVD., SUITE 101, MELBOURNE, FL 32940 | No data |
| CHANGE OF MAILING ADDRESS | 2011-03-01 | 3270 SUNTREE BLVD., SUITE 101, MELBOURNE, FL 32940 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J18000127126 | ACTIVE | 1000000776647 | BREVARD | 2018-03-19 | 2028-03-28 | $ 243.74 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MELBOURNE SERVICE CENTER, 6300 N WICKHAM RD STE 133A, MELBOURNE FL329402029 |
| J10000356755 | TERMINATED | 1000000154027 | BREVARD | 2010-02-18 | 2030-02-24 | $ 502.50 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, COCOA SERVICE CENTER, 2428 CLEARLAKE RD STE M, COCOA FL329225731 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-04-25 |
| ANNUAL REPORT | 2015-01-28 |
| ANNUAL REPORT | 2014-03-14 |
| ANNUAL REPORT | 2013-04-09 |
| ANNUAL REPORT | 2012-01-11 |
| REINSTATEMENT | 2011-03-01 |
| ANNUAL REPORT | 2009-03-05 |
| Domestic Profit | 2008-04-16 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
