{"entity":{"id":10975748,"state":"FL","state_id":"N04000000205","entity_name":"PROVIDENCE M.B. CHURCH, INC.","entity_type":"DOMNP","entity_type_normalized":"domestic_nonprofit","status":"A","filing_date":"2004-01-05","filing_year":2004,"business_age_years":22,"principal_address1":"4561 DOUGLAS AVENUE","principal_address2":"","principal_city":"LAKE MONROE","principal_state":"FL","principal_zip":"32747","principal_country":"","mail_address1":"PO BOX 407579","mail_address2":"","mail_city":"LAKE MONROE","mail_state":"FL","mail_zip":"32747","mail_country":"US","location_name":null,"location_address1":null,"location_address2":null,"location_city":null,"location_state":null,"location_zip":null,"fei_ein":"134209652","jurisdiction":null,"county":null,"last_transaction_date":"11152020","report_year_1":"2025","report_date_1":"04292025","report_year_2":"2025","report_date_2":"04292025","report_year_3":"2024","report_date_3":"04152024","agent_name":"Carlton B Edge","agent_type":"P","agent_address":"4561 Douglas Avenue","agent_city":"Lake Monroe","agent_state":"FL","agent_zip":"32747","process_name":null,"process_address1":null,"process_address2":null,"process_city":null,"process_state":null,"process_zip":null,"source_file":"cordata5.txt","fetched_at":"2026-05-09 12:48:43","updated_at":"2026-05-09 12:48:43","last_accessed":null,"status_reason":null,"agent_name_raw":"EDGE                CARLTON       B"},"officers":[{"name":"Dexter Brown","first_name":"Dexter","last_name":"Brown","title":"deac","title_roles":[],"title_code":"deac","is_registered_agent":false,"address":"4561 DOUGLAS STREET","city":"LAKE MONROE","state":"FL","zip":"32747","name_raw":"Brown               Dexter"},{"name":"Voncile S Davis","first_name":"Voncile","last_name":"Davis","title":"Secretary","title_roles":["Secretary"],"title_code":"sec","is_registered_agent":false,"address":"4660 GILBERT STREET","city":"SANFORD","state":"FL","zip":"32771","name_raw":"DAVIS               VONCILE       S"},{"name":"Carlton B Edge","first_name":"Carlton","last_name":"Edge","title":"Trustee","title_roles":["Trustee"],"title_code":"trus","is_registered_agent":true,"address":"4501 GILBERT STREET","city":"SANFORD","state":"FL","zip":"32771","name_raw":"EDGE                CARLTON       B"}],"filing_history":[],"status_history":[],"unknown":["status_history: we do not collect status-change histories from the source feeds, so this empty list means we hold none — NOT that this company's status has never changed. Observed changes we DID see are under `history`."],"verified_domains":[],"history":null,"web_contact":null,"provenance_url":"https://private.rootz.global/api/provenance/FL/N04000000205"}