| Entity Name: | INTEGRAS THERAPY & WELLNESS CENTERS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 25 Jan 1999 (26 years ago) |
| Date of dissolution: | 07 Dec 2016 (8 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 07 Dec 2016 (8 years ago) |
| Document Number: | P99000008358 |
| FEI/EIN Number | 631219537 |
| Address: | 17352 MAIN STREET NORTH, 17352 MAIN ST. NORTH, BLOUNTSTOWN, FL, 32424, UN |
| Mail Address: | 17352 MAIN STREET NORTH, 17352 MAIN ST. NORTH, BLOUNTSTOWN, FL, 32424 |
| ZIP code: | 32424 |
| County: | Calhoun |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922034552 | 2006-06-24 | 2008-06-18 | 17352 MAIN ST N, BLOUNTSTOWN, FL, 324241763, US | 17352 MAIN ST N, BLOUNTSTOWN, FL, 324241763, US | |||||||||||||||||||||||
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| Phone | +1 850-674-7639 |
| Fax | 8506744305 |
| Phone | +1 850-674-4300 |
Authorized person
| Name | MR. CHAUNCY BELSER |
| Role | PHYSICAL THERAPIST, COO |
| Phone | 8506747639 |
Taxonomy
| Taxonomy Code | 261QR0400X - Rehabilitation Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 890142200 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| INTEGRAS THERAPY & WELLNESS CENTERS, INC. 401(K) PLAN | 2011 | 631219537 | 2012-10-05 | INTEGRAS THERAPY & WELLNESS CENTERS, INC. | 74 | |||||||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 631219537 |
| Plan administrator’s name | INTEGRAS THERAPY & WELLNESS CENTERS, INC. |
| Plan administrator’s address | 17352 MAIN STREET NORTH, BLOUNTSTOWN, FL, 32424 |
| Administrator’s telephone number | 8506747639 |
Signature of
| Role | Plan administrator |
| Date | 2012-10-05 |
| Name of individual signing | CHAUNCEY BELSER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1998-01-01 |
| Business code | 621399 |
| Sponsor’s telephone number | 8506747639 |
| Plan sponsor’s address | 17352 MAIN STREET NORTH, BLOUNTSTOWN, FL, 32424 |
Plan administrator’s name and address
| Administrator’s EIN | 631219537 |
| Plan administrator’s name | INTEGRAS THERAPY & WELLNESS CENTERS, INC. |
| Plan administrator’s address | 17352 MAIN STREET NORTH, BLOUNTSTOWN, FL, 32424 |
| Administrator’s telephone number | 8506747639 |
Signature of
| Role | Plan administrator |
| Date | 2011-07-06 |
| Name of individual signing | CHAUNCEY BELSER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1998-01-01 |
| Business code | 621399 |
| Sponsor’s telephone number | 8506747639 |
| Plan sponsor’s address | 17352 MAIN STREET NORTH, BLOUNTSTOWN, FL, 32424 |
Plan administrator’s name and address
| Administrator’s EIN | 631219537 |
| Plan administrator’s name | INTEGRAS THERAPY & WELLNESS CENTERS, INC. |
| Plan administrator’s address | 17352 MAIN STREET NORTH, BLOUNTSTOWN, FL, 32424 |
| Administrator’s telephone number | 8506747639 |
Signature of
| Role | Plan administrator |
| Date | 2010-09-24 |
| Name of individual signing | CHAUNCEY BELSER |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2010-09-24 |
| Name of individual signing | CHAUNCEY BELSER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| BELSER CHAUNCEY C | Agent | 1428 STATE PARK ROAD, CHIPLEY, FL, 32428 |
| Name | Role | Address |
|---|---|---|
| WILLIAMS WILLIAM C | Director | 73 Scribner Avenue, DeFuniak Springs, FL, 32435 |
| BELSER CHAUNCEY | Director | 1428 STATE PARK RD., CHIPLEY, FL, 32428 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2016-12-07 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-04-27 | 17352 MAIN STREET NORTH, 17352 MAIN ST. NORTH, BLOUNTSTOWN, FL 32424 UN | No data |
| CHANGE OF MAILING ADDRESS | 2011-04-27 | 17352 MAIN STREET NORTH, 17352 MAIN ST. NORTH, BLOUNTSTOWN, FL 32424 UN | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-04-27 | 1428 STATE PARK ROAD, 17352 MAIN ST. NORTH, CHIPLEY, FL 32428 | No data |
| REGISTERED AGENT NAME CHANGED | 2008-04-10 | BELSER, CHAUNCEY COO | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J10001121513 | LAPSED | 2010-CA-000305 | GULF CTY. CIR. CT. | 2010-12-13 | 2015-12-20 | $316,487.89 | REGIONS BANK, 70 N. BAYLEN STREET, 2ND FLOOR, PENSACOLA, FL 32502 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-04-04 |
| ANNUAL REPORT | 2015-04-29 |
| ANNUAL REPORT | 2014-04-24 |
| ANNUAL REPORT | 2013-04-30 |
| ANNUAL REPORT | 2012-04-27 |
| ANNUAL REPORT | 2011-04-27 |
| ANNUAL REPORT | 2010-04-14 |
| ANNUAL REPORT | 2009-04-24 |
| ANNUAL REPORT | 2008-04-10 |
| ANNUAL REPORT | 2007-04-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
