| Entity Name: | SUPPORTIVE HEALTHCARE, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 11 Sep 2012 (12 years ago) |
| Document Number: | P12000077118 |
| FEI/EIN Number | 46-0966843 |
| Address: | 14000 S. Military Trail, Ste 202, Delray Beach, FL 33484 |
| Mail Address: | 14000 S. Military Trail, Ste 202, Delray Beach, FL 33484 |
| ZIP code: | 33484 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063763944 | 2012-10-02 | 2012-11-20 | 2337 VINTAGE DR, LIGHTHOUSE POINT, FL, 330646089, US | 14000 S MILITARY TRL, DELRAY BEACH, FL, 334842610, US | |||||||||||||||||||||||||
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| Phone | +1 561-307-1801 |
Authorized person
| Name | MARK GERHARDT |
| Role | OWNER/PRESIDENT |
| Phone | 5612348881 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SUPPORTIVE HEALTHCARE, INC 401(K) PLAN | 2020 | 460966843 | 2021-09-17 | SUPPORTIVE HEALTHCARE, INC. | 0 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 621874769 |
| Plan administrator’s name | TAG RESOURCES, LLC |
| Plan administrator’s address | 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919 |
| Administrator’s telephone number | 8656701844 |
Signature of
| Role | Plan administrator |
| Date | 2021-09-17 |
| Name of individual signing | PHIL TISUE |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| Fluxman, Lisa | President | 14000 S. Military Trail, Ste 202 Delray Beach, FL 33484 |
| Name | Role | Address |
|---|---|---|
| Beck, Martin S.A | Chairman of the Board | 14000 S. Military Trail, Ste 202 Delray Beach, FL 33484 |
| Name | Role | Address |
|---|---|---|
| Clark, Michael | Comptroller | 14000 S. Military Trail, Ste 202 Delray Beach, FL 33484 |
| Name | Role | Address |
|---|---|---|
| Balakrishnan, Ramesh, Dr. | Authorized Signor | 14000 S. Military Trail, Ste 202 Delray Beach, FL 33484 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-22 | 14000 S. Military Trail, Ste 202, Delray Beach, FL 33484 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-22 | 14000 S. Military Trail, Ste 202, Delray Beach, FL 33484 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-12-20 | C T CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-12-20 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-22 |
| ANNUAL REPORT | 2023-04-29 |
| Reg. Agent Change | 2022-12-20 |
| ANNUAL REPORT | 2022-04-12 |
| ANNUAL REPORT | 2021-01-22 |
| ANNUAL REPORT | 2020-02-20 |
| AMENDED ANNUAL REPORT | 2019-10-04 |
| ANNUAL REPORT | 2019-01-30 |
| ANNUAL REPORT | 2018-04-15 |
| ANNUAL REPORT | 2017-04-13 |
Date of last update: 23 Jan 2025
Sources: Florida Department of State
