Menu
Search icon
  1. Home Page
    2. ›
  2. Counties
    3. ›
  3. Brevard
    4. ›
  4. 32955
    5. ›
  5. BEHAVIOR SERVICES OF BREVARD, INC.

BEHAVIOR SERVICES OF BREVARD, INC.

Company Details

Entity Name: BEHAVIOR SERVICES OF BREVARD, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 14 Jul 1997 (28 years ago)
Document Number: P97000063864
FEI/EIN Number 593454773
Address: 550 SOLUTIONS WAY, ROCKLEDGE, FL, 32955, US
Mail Address: 550 SOLUTIONS WAY, ROCKLEDGE, FL, 32955, US
ZIP code: 32955
County: Brevard
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1548464423 2007-06-13 2017-03-15 550 SOLUTIONS WAY, ROCKLEDGE, FL, 329553620, US 550 SOLUTIONS WAY, ROCKLEDGE, FL, 329553620, US

Contacts
Phone +1 321-639-9800
Fax 3216396007

Authorized person
Name KAREN R WAGNER
Role PRESIDENT CEO
Phone 3216399800

Taxonomy
Taxonomy Code 103K00000X - Behavior Analyst
Is Primary No
Taxonomy Code 106E00000X - Assistant Behavior Analyst
Is Primary No
Taxonomy Code 106S00000X - Behavior Technician
Is Primary No
Taxonomy Code 251C00000X - Developmentally Disabled Services Day Training Agency
State FL
Is Primary No
Taxonomy Code 251S00000X - Community/Behavioral Health Agency
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 675637996
State FL
Issuer MEDICAID
Number 003366900
State FL
Issuer MEDICAID
Number 675637998
State FL
Issuer MEDICAID
Number 003125600
State FL
Issuer MEDICAID
Number 017452000
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EMPLOYEE BENEFIT PLAN OF BEHAVIOR SERVICES. OF BREVARD, INC. 2018 593454773 2019-08-27 BEHAVIOR SERVICES OF BREVARD, INC 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-11-01
Business code 621330
Sponsor’s telephone number 3216399800
Plan sponsor’s address 550 SOLUTIONS WAY, ROCKLEDGE, FL, 329553620

Signature of
Role Plan administrator
Date 2019-08-27
Name of individual signing GINA LACOSTE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-08-27
Name of individual signing GINA LACOSTE
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF BEHAVIOR SERVICES OF BREVARD, INC. 2017 593454773 2018-12-10 BEHAVIOR SERVICES OF BREVARD, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-11-01
Business code 621330
Plan sponsor’s address 550 SOLUTIONS WAY, ROCKLEDGE, FL, 329553620

Signature of
Role Plan administrator
Date 2018-12-10
Name of individual signing GINA LACOSTE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-12-10
Name of individual signing GINA LACOSTE
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF BEHAVIOR SERVICES OF BREVARD, INC. 2016 593454773 2018-12-10 BEHAVIOR SERVICES OF BREVARD, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-11-01
Business code 621330
Sponsor’s telephone number 3216399800
Plan sponsor’s address 550 SOLUTIONS WAY, ROCKLEDGE, FL, 329553620

Signature of
Role Plan administrator
Date 2018-12-10
Name of individual signing GINA LACOSTE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-12-10
Name of individual signing GINA LACOSTE
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF BEHAVIOR SERVICES OF BREVARD, INC. 2015 593454773 2016-07-29 BEHAVIOR SERVICES OF BREVARD, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-11-01
Business code 621330
Sponsor’s telephone number 3216399800
Plan sponsor’s address 550 SAINT JOHNS ST, COCOA, FL, 32922

Signature of
Role Plan administrator
Date 2016-07-29
Name of individual signing WENDIE PHILLIPS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-29
Name of individual signing WENDIE PHILLIPS
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF BEHAVIOR SERVICES OF BREVARD, INC. 2014 593454773 2015-07-09 BEHAVIOR SERVICES OF BREVARD, INC. 8
Three-digit plan number (PN) 001
Effective date of plan 2010-11-01
Business code 621330
Sponsor’s telephone number 3216399800
Plan sponsor’s address 550 SAINT JOHNS ST, COCOA, FL, 32922

Signature of
Role Plan administrator
Date 2015-07-09
Name of individual signing APRIL KINGSLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-09
Name of individual signing APRIL KINGSLEY
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF BEHAVIOR SERVICES OF BREVARD, INC. 2014 593454773 2015-07-09 BEHAVIOR SERVICES OF BREVARD, INC. 8
Three-digit plan number (PN) 001
Effective date of plan 2010-11-01
Business code 621330
Sponsor’s telephone number 3216399800
Plan sponsor’s address 550 SAINT JOHNS ST, COCOA, FL, 32922

Signature of
Role Plan administrator
Date 2015-07-09
Name of individual signing APRIL KINGSLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-09
Name of individual signing APRIL KINGSLEY
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF BEHAVIOR SERVICES OF BREVARD, INC. 2014 593454773 2015-07-09 BEHAVIOR SERVICES OF BREVARD, INC. 8
Three-digit plan number (PN) 001
Effective date of plan 2010-11-01
Sponsor’s telephone number 3216399800
Plan sponsor’s address 550 SAINT JOHNS ST, COCOA, FL, 32922

Signature of
Role Plan administrator
Date 2015-07-09
Name of individual signing ELAINE HINKLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-09
Name of individual signing ELAINE HINKLEY
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF BEHAVIOR SERVICES OF BREVARD, INC. 2014 593454773 2015-07-20 BEHAVIOR SERVICES OF BREVARD, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-11-01
Business code 621330
Sponsor’s telephone number 3216399800
Plan sponsor’s address 550 SAINT JOHNS ST, COCOA, FL, 32922

Signature of
Role Plan administrator
Date 2015-07-20
Name of individual signing ELAINE HINKLEY
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF BEHAVIOR SERVICES OF BREVARD, INC. 2014 593454773 2015-07-09 BEHAVIOR SERVICES OF BREVARD, INC. 8
Three-digit plan number (PN) 001
Effective date of plan 2010-11-01
Sponsor’s telephone number 3216399800
Plan sponsor’s address 550 SAINT JOHNS ST, COCOA, FL, 32922

Signature of
Role Plan administrator
Date 2015-07-09
Name of individual signing ELAINE HINKLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-09
Name of individual signing ELAINE HINKLEY
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF BEHAVIOR SERVICES OF BREVARD, INC. 2013 593454773 2014-07-28 BEHAVIOR SERVICES OF BREVARD, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-11-01
Business code 621330
Sponsor’s telephone number 3216399800
Plan sponsor’s address 550 SAINT JOHNS ST, COCOA, FL, 32922

Signature of
Role Plan administrator
Date 2014-07-28
Name of individual signing ELAINE HINKLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-28
Name of individual signing ELAINE HINKLEY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
WAGNER KAREN R Agent 550 SOLUTIONS WAY, ROCKLEDGE, FL, 32955

President

Name Role Address
WAGNER KAREN R President 550 SOLUTIONS WAY, ROCKLEDGE, FL, 32955

Vice President

Name Role Address
WAGNER KAREN R Vice President 550 SOLUTIONS WAY, ROCKLEDGE, FL, 32955

Treasurer

Name Role Address
WAGNER KAREN R Treasurer 550 SOLUTIONS WAY, ROCKLEDGE, FL, 32955

Secretary

Name Role Address
WAGNER KAREN R Secretary 550 SOLUTIONS WAY, ROCKLEDGE, FL, 32955

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G19000033630 WORKABLE EXPIRED 2019-03-13 2024-12-31 No data 550 SOLUTIONS WAY, ROCKLEDGE, FL, 32955
G19000027721 BEHAVIOR EDUCATION CENTER ACTIVE 2019-02-27 2029-12-31 No data 550 SOLUTIONS WAY, ROCKLEDGE, FL, 32833

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2019-03-15 550 SOLUTIONS WAY, ROCKLEDGE, FL 32955 No data
CHANGE OF PRINCIPAL ADDRESS 2016-10-10 550 SOLUTIONS WAY, ROCKLEDGE, FL 32955 No data
CHANGE OF MAILING ADDRESS 2016-10-10 550 SOLUTIONS WAY, ROCKLEDGE, FL 32955 No data
REGISTERED AGENT NAME CHANGED 2005-04-21 WAGNER, KAREN RCEO No data

Documents

Name Date
ANNUAL REPORT 2024-01-18
ANNUAL REPORT 2023-01-18
ANNUAL REPORT 2022-02-17
ANNUAL REPORT 2021-03-02
ANNUAL REPORT 2020-03-16
ANNUAL REPORT 2019-03-15
ANNUAL REPORT 2018-04-11
ANNUAL REPORT 2017-03-16
ANNUAL REPORT 2016-01-04
ANNUAL REPORT 2015-03-18

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

Privacy policy Policy
About us About us
Contacts Contact us

© 2025 flprofile.com, Part of Big Data Integrated