| Entity Name: | HOMESTEAD BEHAVIORAL CLINIC, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 10 Feb 1997 (28 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 16 Dec 2003 (21 years ago) |
| Document Number: | P97000014001 |
| FEI/EIN Number | 65-0786282 |
| Address: | 654 NE 9TH PLACE, HOMESTEAD, FL 33030 |
| Mail Address: | 654 NE 9TH PLACE, HOMESTEAD, FL 33030 |
| ZIP code: | 33030 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881264091 | 2021-06-29 | 2021-06-29 | 654 NE 9TH PL, HOMESTEAD, FL, 330304934, US | 654 NE 9TH PL, HOMESTEAD, FL, 330304934, US | |||||||||||||||||||||
|
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| Phone | +1 305-248-3488 |
| Fax | 3052486558 |
Authorized person
| Name | AIDELYN LOPEZ |
| Role | PRESIDENT |
| Phone | 3052483488 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 260257100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LOPEZ, AIDELYN | Agent | 3520 SW 128TH AVE, MIAMI, FL 33175 |
| Name | Role | Address |
|---|---|---|
| LOPEZ, AIDELYN | Vice President | 654 NE 9TH PLACE, HOMESTEAD, FL 33030 |
| Name | Role |
|---|---|
| HOMESTEAD HEALTH CLINIC LLC | President |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000125487 | HOMESTEAD BEHAVIORAL CLINIC "HBC" | ACTIVE | 2024-10-09 | 2029-12-31 | No data | 654 NE 9TH PLACE, HOMESTEAD, FL, 33030 |
| G23000064639 | HOMESTEAD BEHAVIORAL CLINIC, "HBC" | ACTIVE | 2023-05-24 | 2028-12-31 | No data | 654 NE 9TH PLACE, HOMESTEAD, FL, 33030 |
| G16000025912 | HOMESTEAD BEHAVIORAL CLINIC, "HBC" | EXPIRED | 2016-03-10 | 2021-12-31 | No data | 654 NE 9TH PLACE, HOMESTEAD, FL, 33030 |
| G08254900149 | HOMESTEAD BEHAVIORAL CLINIC, ADULT DAY CARE | EXPIRED | 2008-09-10 | 2013-12-31 | No data | 654 NE 9TH PLACE, HOMESTEAD, FL, 33030 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2007-01-05 | 654 NE 9TH PLACE, HOMESTEAD, FL 33030 | No data |
| CHANGE OF MAILING ADDRESS | 2007-01-05 | 654 NE 9TH PLACE, HOMESTEAD, FL 33030 | No data |
| REINSTATEMENT | 2003-12-16 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2003-12-16 | 3520 SW 128TH AVE, MIAMI, FL 33175 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2003-09-19 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-14 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-01-25 |
| ANNUAL REPORT | 2021-01-12 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-01-08 |
| ANNUAL REPORT | 2017-01-04 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-03-05 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
