| Entity Name: | BREAKTHROUGH CARE AND RESOURCE CENTER INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 10 Apr 2019 (6 years ago) |
| Last Event: | CONVERSION |
| Event Date Filed: | 10 Apr 2019 (6 years ago) |
| Document Number: | P19000032771 |
| FEI/EIN Number | 87-1614994 |
| Address: | 19821 Northwest 2nd Avenue, Suite 157, Miami, FL, 33169, US |
| Mail Address: | 19821 NW 2ND AVE STE 157, MIAMI, FL, 33169, US |
| ZIP code: | 33169 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285177055 | 2016-11-28 | 2021-12-27 | 19821 NW 2ND AVE STE 157, MIAMI GARDENS, FL, 331693341, US | 7971 RIVIERA BLVD STE 316, MIRAMAR, FL, 330236448, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-494-2798 |
| Fax | 8882846382 |
| Phone | +1 305-570-4064 |
Authorized person
| Name | DELPHINE GERVAIS |
| Role | CEO |
| Phone | 3054942798 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | Yes |
| Taxonomy Code | 106H00000X - Marriage & Family Therapist |
| Is Primary | No |
| Taxonomy Code | 305S00000X - Point of Service |
| License Number | SW 11931 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 014020500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GERVAIS DELPHINE | Agent | 19821 NW 2ND AVE STE 157, MIAMI, FL, 33169 |
| Name | Role | Address |
|---|---|---|
| GERVAIS DELPHINE | President | 19821 NW 2ND AVE STE 157, MIAMI, FL, 33169 |
| Name | Role | Address |
|---|---|---|
| Gervais Eddy | Manager | 19821 NW 2ND AVE STE 157, MIAMI, FL, 33169 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-01-30 | 19821 Northwest 2nd Avenue, Suite 157, Miami, FL 33169 | No data |
| CONVERSION | 2019-04-10 | No data | CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS L15000152582. CONVERSION NUMBER 700000192147 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-30 |
| ANNUAL REPORT | 2023-02-06 |
| ANNUAL REPORT | 2022-03-19 |
| ANNUAL REPORT | 2021-01-11 |
| ANNUAL REPORT | 2020-01-16 |
| Domestic Profit | 2019-04-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
