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  5. FLORIDA PALMS ACADEMY, INC.

FLORIDA PALMS ACADEMY, INC.

Company Details

Entity Name: FLORIDA PALMS ACADEMY, INC.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Active
Date Filed: 02 Apr 2013 (12 years ago)
Last Event: AMENDMENT
Event Date Filed: 26 Jun 2013 (12 years ago)
Document Number: P13000030365
FEI/EIN Number 46-2449539
Address: 10540 LA REINA ROAD, DELRAY BEACH, FL 33446
Mail Address: 10540 LA REINA ROAD, DELRAY BEACH, FL 33446
ZIP code: 33446
County: Palm Beach
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1104268085 2013-07-22 2013-07-22 10001 W OAKLAND PARK BLVD, STE 200, SUNRISE, FL, 333516925, US 5925 MCKINLEY ST, HOLLYWOOD, FL, 330214560, US

Contacts
Phone +1 954-746-5200
Fax 9547465216
Phone +1 954-963-0991
Fax 9549633956

Authorized person
Name DR. DAVID L FERGUSON
Role PRESIDENT
Phone 9547465200

Taxonomy
Taxonomy Code 322D00000X - Emotionally Disturbed Childrens' Residential Treatment Facility
License Number 44
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 029582516
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FLORIDA PALMS ACADEMY, INC. RETIREMENT PLAN 2023 462449539 2024-10-08 FLORIDA PALMS ACADEMY, INC. 93
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 624100
Sponsor’s telephone number 9547465200
Plan sponsor’s address 10001 W. OAKLAND PARK BLVD, STE 200, SUNRISE, FL, 33351

Signature of
Role Plan administrator
Date 2024-10-08
Name of individual signing RONALD SIMON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-10-08
Name of individual signing RONALD SIMON
Valid signature Filed with authorized/valid electronic signature
FLORIDA PALMS ACADEMY, INC. RETIREMENT PLAN 2022 462449539 2023-09-12 FLORIDA PALMS ACADEMY, INC. 91
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 624100
Sponsor’s telephone number 9547465200
Plan sponsor’s address 10001 W. OAKLAND PARK BLVD, STE 200, SUNRISE, FL, 33351

Signature of
Role Plan administrator
Date 2023-09-12
Name of individual signing RONALD SIMON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-09-12
Name of individual signing RONALD SIMON
Valid signature Filed with authorized/valid electronic signature
FLORIDA PALMS ACADEMY, INC. RETIREMENT PLAN 2021 462449539 2022-08-11 FLORIDA PALMS ACADEMY, INC. 107
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 624100
Sponsor’s telephone number 9547465200
Plan sponsor’s address 10001 W. OAKLAND PARK BLVD, STE 200, SUNRISE, FL, 33351

Signature of
Role Plan administrator
Date 2022-08-11
Name of individual signing RONALD SIMON
Valid signature Filed with authorized/valid electronic signature
FLORIDA PALMS ACADEMY, INC. RETIREMENT PLAN 2020 462449539 2021-10-11 FLORIDA PALMS ACADEMY, INC. 112
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 624100
Sponsor’s telephone number 9547465200
Plan sponsor’s address 10001 W. OAKLAND PARK BLVD, STE 200, SUNRISE, FL, 33351

Signature of
Role Plan administrator
Date 2021-10-11
Name of individual signing RONALD SIMON
Valid signature Filed with authorized/valid electronic signature
FLORIDA PALMS ACADEMY, INC. RETIREMENT PLAN 2019 462449539 2020-10-06 FLORIDA PALMS ACADEMY, INC. 119
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 624100
Sponsor’s telephone number 9547465200
Plan sponsor’s address 10001 W. OAKLAND PARK BLVD, STE 200, SUNRISE, FL, 33351

Signature of
Role Plan administrator
Date 2020-10-06
Name of individual signing RONALD SIMON
Valid signature Filed with authorized/valid electronic signature
FLORIDA PALMS ACADEMY, INC. RETIREMENT PLAN 2018 462449539 2019-10-01 FLORIDA PALMS ACADEMY, INC. 95
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 624100
Sponsor’s telephone number 9547465200
Plan sponsor’s address 10001 W. OAKLAND PARK BLVD, STE 200, SUNRISE, FL, 33351

Signature of
Role Plan administrator
Date 2019-10-01
Name of individual signing RONALD SIMON
Valid signature Filed with authorized/valid electronic signature
FLORIDA PALMS ACADEMY, INC. RETIREMENT PLAN 2017 462449539 2018-10-08 FLORIDA PALMS ACADEMY, INC. 113
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 624100
Sponsor’s telephone number 9547465200
Plan sponsor’s address 10001 W. OAKLAND PARK BLVD, STE 200, SUNRISE, FL, 33351

Signature of
Role Plan administrator
Date 2018-10-08
Name of individual signing RONALD SIMON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-08
Name of individual signing RONALD SIMON
Valid signature Filed with authorized/valid electronic signature
FLORIDA PALMS ACADEMY, INC. RETIREMENT PLAN 2016 462449539 2017-08-28 FLORIDA PALMS ACADEMY, INC. 104
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 624100
Sponsor’s telephone number 9547465200
Plan sponsor’s address 10001 W. OAKLAND PARK BLVD, STE 200, SUNRISE, FL, 33351

Signature of
Role Plan administrator
Date 2017-08-28
Name of individual signing RONALD SIMON
Valid signature Filed with authorized/valid electronic signature
FLORIDA PALMS ACADEMY, INC. RETIREMENT PLAN 2015 462449539 2016-10-05 FLORIDA PALMS ACADEMY, INC. 96
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 624100
Sponsor’s telephone number 9547465200
Plan sponsor’s address 10001 W. OAKLAND PARK BLVD, STE 200, SUNRISE, FL, 33351

Signature of
Role Plan administrator
Date 2016-10-05
Name of individual signing RONALD SIMON
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
SIMON, RONALD D Agent 10540 La Reina Rd, Delray Beach, FL 33446

President

Name Role Address
FERGUSON, DAVID L President 10001 W. Oakland Park Blvd, Suite 200 Sunrise, FL 33351

Sole Director

Name Role Address
FERGUSON, DAVID L Sole Director 10001 W. Oakland Park Blvd, Suite 200 Sunrise, FL 33351

Secretary

Name Role Address
Simon, Ronald D Secretary 10540 LA REINA ROAD, DELRAY BEACH, FL 33446

Treasurer

Name Role Address
Simon, Ronald D Treasurer 10540 LA REINA ROAD, DELRAY BEACH, FL 33446

Comptroller

Name Role Address
Simon, Ariel D Comptroller 10001 W. OAKLAND PARK BLVD, SUITE 200 SUNRISE, FL 33351

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2018-02-04 SIMON, RONALD D No data
REGISTERED AGENT ADDRESS CHANGED 2018-02-04 10540 La Reina Rd, Delray Beach, FL 33446 No data
AMENDMENT 2013-06-26 No data No data

Documents

Name Date
ANNUAL REPORT 2025-01-22
ANNUAL REPORT 2024-01-13
ANNUAL REPORT 2023-01-26
ANNUAL REPORT 2022-03-06
ANNUAL REPORT 2021-01-10
ANNUAL REPORT 2020-01-16
ANNUAL REPORT 2019-02-03
ANNUAL REPORT 2018-02-04
ANNUAL REPORT 2017-01-12
ANNUAL REPORT 2016-03-04

Related by officers

SIMON, RONALD D

JCF REALTY IV, LLC JCF REALTY III, LLC JCF REALTY I, LLC JCF-DD REALTY IX, LLC ALTERNATE GROUP CARE, INC. ALTERNATE EDUCATIONAL SYSTEMS PROPERTY 4, LLC ALTERNATE EDUCATIONAL SYSTEMS PROPERTY 3, LLC VISTA MERCADO, INC. ALTERNATE EDUCATIONAL SYSTEMS PROPERTY 1, LLC ALTERNATE FAMILY HOLDING, LLC

FERGUSON, DAVID L

ALTERNATE GROUP CARE, INC. WESTBRIDGE HOLDINGS, LLC WESTBRIDGE HOLDINGS II, LLC HALIFAX MEDIATION GROUP LLC D.L. FERGUSON MINISTRIES, INC.

Simon, Ronald D

ALTERNATE GROUP CARE, INC.

Related by address

10540 LA REINA ROAD, DELRAY BEACH, FL 33446

ALTERNATE GROUP CARE, INC. ALTERNATE EDUCATIONAL SYSTEMS PROPERTY 4, LLC

10540 LA REINA ROAD, DELRAY BEACH, FL 33446

ALTERNATE GROUP CARE, INC. ALTERNATE EDUCATIONAL SYSTEMS PROPERTY 4, LLC

Date of last update: 22 Jan 2025

Sources: Florida Department of State

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