| Entity Name: | HALE THERAPY SERVICE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 29 Sep 1997 (27 years ago) |
| Document Number: | P97000084695 |
| FEI/EIN Number | 650782380 |
| Address: | 14410 Metropolis Ave, FT. MYERS, FL, 33912, US |
| Mail Address: | 12691 CHARTWELL DR, FT MYERS, FL, 33912, US |
| ZIP code: | 33912 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1235433343 | 2011-01-04 | 2011-01-04 | 12691 CHARTWELL DR, FORT MYERS, FL, 339124659, US | 12691 CHARTWELL DR, FORT MYERS, FL, 339124659, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 239-561-2778 |
| Fax | 2395618107 |
Authorized person
| Name | MRS. JENNIFER DENISE HALE-WASHBURN |
| Role | PRESIDENT/OCCUPATIONAL THERAPIST |
| Phone | 2396910765 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | 16949 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 225X00000X - Occupational Therapist |
| License Number | OT 7744 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 225X00000X - Occupational Therapist |
| License Number | OT 3614 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| License Number | SA 9721 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 001200800 |
| State | FL |
| Issuer | MEDICAID |
| Number | 001200700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WASHBURN JENNIFER D | Agent | 12691 CHARTWELL DR, FORT MYERS, FL, 33912 |
| Name | Role | Address |
|---|---|---|
| WASHBURN JENNIFER D | Director | 12691 CHARTWELL DR., FT MYERS, FL, 33912 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000027918 | SPOT THERAPY ASSOCIATES | ACTIVE | 2016-03-16 | 2026-12-31 | No data | 14410 METROPOLIS AVE, FORT MYERS, FL, 33912 |
| G11000128680 | SPOT THERAPY ASSOCIATES | EXPIRED | 2011-12-30 | 2016-12-31 | No data | 12691 CHARTWELL DR, FORT MYERS, FL, 33912, US |
| G11000078721 | SPOT THERAPY ASSOCIATES | EXPIRED | 2011-08-08 | 2016-12-31 | No data | 12691 CHARTWELL DR, FORT MYERS, FL, 33912 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-07-14 | 14410 Metropolis Ave, FT. MYERS, FL 33912 | No data |
| CHANGE OF MAILING ADDRESS | 2022-07-14 | 14410 Metropolis Ave, FT. MYERS, FL 33912 | No data |
| REGISTERED AGENT NAME CHANGED | 2008-04-28 | WASHBURN, JENNIFER D | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-04-17 | 12691 CHARTWELL DR, FORT MYERS, FL 33912 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-02-09 |
| ANNUAL REPORT | 2022-03-10 |
| ANNUAL REPORT | 2021-02-19 |
| ANNUAL REPORT | 2020-03-16 |
| ANNUAL REPORT | 2019-03-29 |
| ANNUAL REPORT | 2018-04-02 |
| ANNUAL REPORT | 2017-02-10 |
| ANNUAL REPORT | 2016-02-11 |
| ANNUAL REPORT | 2015-02-25 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
