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BEHAVIORAL HEALTH MEDICAL PRACTICE, P.C.

BEHAVIORAL HEALTH MEDICAL PRACTICE, P.C.

Company Details

Name:	BEHAVIORAL HEALTH MEDICAL PRACTICE, P.C.
Jurisdiction:	New York
Legal type:	DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status:	Active
Date of registration:	22 Sep 2006 (19 years ago)
Entity Number:	3415723
ZIP code:	11772
County:	Suffolk
Place of Formation:	New York
Address:	240 PATCHOGUE YAPHANK RD, STE 211, PATCHOGUE, NY, United States, 11772
Principal Address:	110 FIG DRIVE, DIX HILLS, NY, United States, 11746

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

form 5500

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

BEHAVIORAL HEALTH MEDICAL PRACTICE P.C. 401K PLAN

2023

061803736

2024-06-10

BEHAVIORAL HEALTH MEDICAL PRACTICE P.C.

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2022-01-01
Business code	621112
Sponsor’s telephone number	5163149058
Plan sponsor’s address	240 PATCHOGUE YAPHANK ROAD #211, PATCHOGUE, NY, 11772

BEHAVIORAL HEALTH MEDICAL PRACTICE P.C. 401K PLAN

2022

061803736

2023-09-06

BEHAVIORAL HEALTH MEDICAL PRACTICE P.C.

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2022-01-01
Business code	621112
Sponsor’s telephone number	5163149058
Plan sponsor’s address	240 PATCHOGUE YAPHANK ROAD #211, PATCHOGUE, NY, 11772

Agent

Name	Role	Address
MOATAZ YOUSEF HAGGAG	Agent	200 EAST MAIN STREET, PATCHOGUE, NY, 11772

DOS Process Agent

Name	Role	Address
THE CORPORATION	DOS Process Agent	240 PATCHOGUE YAPHANK RD, STE 211, PATCHOGUE, NY, United States, 11772

Chief Executive Officer

Name	Role	Address
MOATAZ YOUSEF HAGGAG	Chief Executive Officer	110 FIG DRIVE, DIX HILLS, NY, United States, 11746

History

Start date	End date	Type	Value
2010-09-09	2012-10-03	Address	240 PATCHOGUE YAPHANK RD, STE 211, PATCHOGUE, NY, 11772, USA (Type of address: Service of Process)
2006-09-22	2010-09-09	Address	200 EAST MAIN STREET, PATCHOGUE, NY, 11772, USA (Type of address: Service of Process)

Filings

Filing Number	Date Filed	Type	Effective Date
121003002065	2012-10-03	BIENNIAL STATEMENT	2012-09-01
100909002727	2010-09-09	BIENNIAL STATEMENT	2010-09-01
080915002692	2008-09-15	BIENNIAL STATEMENT	2008-09-01
061205000523	2006-12-05	CERTIFICATE OF AMENDMENT	2006-12-05
060922000035	2006-09-22	CERTIFICATE OF INCORPORATION	2006-09-22

Paycheck Protection Program

Loan Number

Loan Funded Date

SBA Origination Office Code

Loan Delivery Method

Borrower Street Address

7421107806

2020-06-03

0235

PPP

110 Fig Dr, HUNTINGTON STATION, NY, 11746-5657

Loan Status Date	2021-08-21
Loan Status	Paid in Full
Loan Maturity in Months	24
SBA Guaranty Percentage	100
Loan Approval Amount (at origination)	37500
Loan Approval Amount (current)	37500
Undisbursed Amount	0
Franchise Name	-
Lender Location ID	48270
Servicing Lender Name	JPMorgan Chase Bank, National Association
Servicing Lender Address	1111 Polaris Pkwy, COLUMBUS, OH, 43240-2031
Rural or Urban Indicator	U
Hubzone	N
LMI	N
Business Age Description	Existing or more than 2 years old
Project Address	HUNTINGTON STATION, SUFFOLK, NY, 11746-5657
Project Congressional District	NY-01
Number of Employees	6
NAICS code	621399
Borrower Race	White
Borrower Ethnicity	Not Hispanic or Latino
Business Type	Corporation
Originating Lender ID	194093
Originating Lender Name	JPMorgan Chase Bank, National Association
Originating Lender Address	CHICAGO, IL
Gender	Male Owned
Veteran	Non-Veteran
Forgiveness Amount	37907.31
Forgiveness Paid Date	2021-07-09

Date of last update: 28 Mar 2025

Sources: New York Secretary of State