| Entity Name: | ACTIVE COMMUNITY HEALTH CENTER CORP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 12 Apr 2013 (12 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 22 Jul 2013 (12 years ago) |
| Document Number: | P13000033461 |
| FEI/EIN Number | 46-2531740 |
| Address: | 1060 SUNSET STRIP, SUNRISE, FL, 33313-6106, US |
| Mail Address: | 19321 SW 14th Street, PEMBROKE PINES, FL, 33029, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245801091 | 2021-07-02 | 2021-07-19 | 19321 SW 14TH ST, PEMBROKE PINES, FL, 330296124, US | 6830 PINES BLVD, PEMBROKE PINES, FL, 330247545, US | |||||||||||||||||||||||
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| Phone | +1 954-394-3095 |
| Fax | 9543338621 |
| Phone | +1 954-333-8787 |
Authorized person
| Name | PABLO URIARTE |
| Role | CEO |
| Phone | 9543943095 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 008779301 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ACTIVE COMMUNITY HEALTH CENTER 401(K) PLAN | 2023 | 462531740 | 2024-07-22 | ACTIVE COMMUNITY HEALTH CENTER | 22 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-07-22 |
| Name of individual signing | CHRIS HORNE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2023-01-01 |
| Business code | 621420 |
| Sponsor’s telephone number | 9543338787 |
| Plan sponsor’s address | 1060 SUNSET STRIP, SUNRISE, FL, 33313 |
Signature of
| Role | Plan administrator |
| Date | 2024-11-01 |
| Name of individual signing | CHRIS HORNE |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Uriarte Pablo | Agent | 19321 SW 14th Street, PEMBROKE PINES, FL, 33029 |
| Name | Role | Address |
|---|---|---|
| Uriarte Pablo | Chief Executive Officer | 19321 SW 14th Street, PEMBROKE PINES, FL, 33029 |
| Name | Role | Address |
|---|---|---|
| Uriarte Patricia | Chairman | 19321 SW 14th Street, PEMBROKE PINES, FL, 33029 |
| Uriarte Patrick | Chairman | 19321 SW 14th Street, PEMBROKE PINES, FL, 33029 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-01-17 | 19321 SW 14th Street, Pembroke Pines, FL 33029-6124 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-04-15 | 1060 SUNSET STRIP, SUNRISE, FL 33313-6106 | No data |
| CHANGE OF MAILING ADDRESS | 2016-03-23 | 1060 SUNSET STRIP, SUNRISE, FL 33313-6106 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-03-23 | 19321 SW 14th Street, PEMBROKE PINES, FL 33029 | No data |
| REGISTERED AGENT NAME CHANGED | 2015-03-08 | Uriarte, Pablo | No data |
| AMENDMENT | 2013-07-22 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-17 |
| ANNUAL REPORT | 2024-03-22 |
| ANNUAL REPORT | 2023-03-09 |
| ANNUAL REPORT | 2022-02-12 |
| ANNUAL REPORT | 2021-03-04 |
| ANNUAL REPORT | 2020-02-28 |
| ANNUAL REPORT | 2019-04-15 |
| ANNUAL REPORT | 2018-03-26 |
| ANNUAL REPORT | 2017-01-13 |
| ANNUAL REPORT | 2016-03-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
