| Entity Name: | HOMESTEAD RESEARCH MENTAL HEALTH INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 03 Oct 2017 (7 years ago) |
| Date of dissolution: | 20 Apr 2023 (2 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 20 Apr 2023 (2 years ago) |
| Document Number: | P17000079804 |
| FEI/EIN Number | 82-3008455 |
| Address: | 17 NE 1ST RD, HOMESTEAD, FL 33030 |
| Mail Address: | 17 NE 1ST RD, HOMESTEAD, FL 33030 |
| ZIP code: | 33030 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669983300 | 2017-10-21 | 2021-03-09 | 317 N KROME AVE, HOMESTEAD, FL, 330306057, US | 317 N KROME AVE, HOMESTEAD, FL, 330306057, US | |||||||||||||||||||||||
|
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| Phone | +1 305-257-8065 |
| Fax | 3055086502 |
Authorized person
| Name | MR. WALEEM ENRIQUE HERNANDEZ |
| Role | OWNER/PRESIDENT |
| Phone | 3052578065 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | PENDING |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 0022753300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ, WALEEM | Agent | 14242 SW 288 TER, HOMESTEAD, FL 33030 |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ, WALEEM E | President | 17 NE 1ST RD, HOMESTEAD, FL 33030 |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ, WALEEM E | Director | 17 NE 1ST RD, HOMESTEAD, FL 33030 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2023-04-20 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-10-27 | 14242 SW 288 TER, HOMESTEAD, FL 33030 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-08-19 | 17 NE 1ST RD, HOMESTEAD, FL 33030 | No data |
| CHANGE OF MAILING ADDRESS | 2021-08-19 | 17 NE 1ST RD, HOMESTEAD, FL 33030 | No data |
| REGISTERED AGENT NAME CHANGED | 2018-05-19 | HERNANDEZ, WALEEM | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2023-04-20 |
| ANNUAL REPORT | 2022-02-26 |
| AMENDED ANNUAL REPORT | 2021-10-27 |
| AMENDED ANNUAL REPORT | 2021-08-19 |
| ANNUAL REPORT | 2021-04-03 |
| ANNUAL REPORT | 2020-02-24 |
| ANNUAL REPORT | 2019-02-13 |
| AMENDED ANNUAL REPORT | 2018-05-24 |
| AMENDED ANNUAL REPORT | 2018-05-19 |
| ANNUAL REPORT | 2018-02-02 |
Date of last update: 18 Jan 2025
Sources: Florida Department of State
