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MARY LEE DEPUGH NURSING HOME ASSOCIATION, INC.

Company Details

Entity Name: MARY LEE DEPUGH NURSING HOME ASSOCIATION, INC.
Jurisdiction: FLORIDA
Filing Type: Florida Not For Profit Corporation
Status: Active
Date Filed: 20 Jun 1968 (57 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 12 Dec 2022 (2 years ago)
Document Number: 714801
FEI/EIN Number 59-1104552
Address: 550 WEST MORSE BLVD., WINTER PARK, FL 32789
Mail Address: 550 WEST MORSE BLVD., WINTER PARK, FL 32789
ZIP code: 32789
County: Orange
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1497870927 2007-03-21 2010-11-18 550 W MORSE BLVD, WINTER PARK, FL, 327894206, US 550 W MORSE BLVD, WINTER PARK, FL, 327894206, US

Contacts

Phone +1 407-644-6634
Fax 4076452520

Authorized person

Name KAREN NORTHOVER
Role ADMINISTRATOR
Phone 4076446634

Taxonomy

Taxonomy Code 314000000X - Skilled Nursing Facility
License Number SNF1324096
State FL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 020158800
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MARY LEE DEPUGH NURSING HOME ASSOCIATION RETIREMENT PLAN 2009 591104552 2010-10-12 MARY LEE DEPUGH NURSING HOME ASSOCIATION 37
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Three-digit plan number (PN) 001
Effective date of plan 1978-06-01
Business code 623000
Sponsor’s telephone number 4076446634
Plan sponsor’s address 550 WEST MORSE BLVD., WINTER PARK, FL, 32789

Plan administrator’s name and address

Administrator’s EIN 591104552
Plan administrator’s name MARY LEE DEPUGH NURSING HOME ASSOCIATION
Plan administrator’s address 550 WEST MORSE BLVD., WINTER PARK, FL, 32789
Administrator’s telephone number 4076446634

Signature of

Role Plan administrator
Date 2010-10-12
Name of individual signing KAREN NORTHOVER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-12
Name of individual signing KAREN NORTHOVER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
The Gardens at Depugh Nursing Center Agent 550 W. MORSE BLVD, WINTER PARK, FL 32789

Vice President

Name Role Address
Weagraff, Beth Vice President 550 WEST MORSE BLVD., WINTER PARK, FL 32789

Director

Name Role Address
Weagraff, Beth Director 550 WEST MORSE BLVD., WINTER PARK, FL 32789

President

Name Role Address
BALDWIN, RICHARD O, JR. President 1550 DALE AVENUE, WINTER PARK, FL 32789

Executive Director

Name Role Address
Barton, Elizabeth K, ED Executive Director 550 W MORSE BLVD, WINTER PARK, FL 32789

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G17000040500 THE GARDENS AT DEPUGH NURSING ACTIVE 2017-04-14 2027-12-31 No data 550 W. MORSE BLVD, WINTER PARK, FL, 32789
G13000005673 THE GARDENS AT DEPUGH EXPIRED 2013-01-16 2018-12-31 No data 550 WEST MORSE BOULEVARD, WINTER PARK, FL, 32789
G09000158756 THE GARDENS AT DEPUGH NURSING CENTER EXPIRED 2009-09-24 2014-12-31 No data 550 WEST MORSE BOULEVARD, WINTER PARK, FL, 32789

Events

Event Type Filed Date Value Description
REINSTATEMENT 2022-12-12 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2022-09-23 No data No data
REGISTERED AGENT NAME CHANGED 2021-02-10 The Gardens at Depugh Nursing Center No data
REINSTATEMENT 2013-10-15 No data No data
REGISTERED AGENT ADDRESS CHANGED 2013-10-15 550 W. MORSE BLVD, WINTER PARK, FL 32789 No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2013-09-27 No data No data
CHANGE OF MAILING ADDRESS 2000-01-26 550 WEST MORSE BLVD., WINTER PARK, FL 32789 No data
CHANGE OF PRINCIPAL ADDRESS 2000-01-26 550 WEST MORSE BLVD., WINTER PARK, FL 32789 No data

Documents

Name Date
ANNUAL REPORT 2025-01-31
ANNUAL REPORT 2024-01-30
ANNUAL REPORT 2023-03-01
REINSTATEMENT 2022-12-12
ANNUAL REPORT 2021-02-10
ANNUAL REPORT 2020-01-15
ANNUAL REPORT 2019-01-28
ANNUAL REPORT 2018-02-01
ANNUAL REPORT 2017-02-09
ANNUAL REPORT 2016-01-25

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
59-1104552 Corporation Unconditional Exemption 550 W MORSE BLVD, WINTER PARK, FL, 32789-4206 1968-07
In Care of Name -
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Organization that receives a substantial part of its support from a governmental unit or the general public 170(b)(1)(A)(vi)
Tax Period 2023-12
Asset 1,000,000 to 4,999,999
Income 5,000,000 to 9,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 4398115
Income Amount 5008792
Form 990 Revenue Amount 5008792
National Taxonomy of Exempt Entities -
Sort Name -

Publication 78 Data

Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)

Organization Name MARY LEE DEPUGH NURSING HOME ASSOCIATION INC
EIN 59-1104552
Tax Period 202212
Filing Type E
Return Type 990
File View File
Organization Name MARY LEE DEPUGH NURSING HOME ASSOCIATION INC
EIN 59-1104552
Tax Period 202112
Filing Type E
Return Type 990
File View File
Organization Name MARY LEE DEPUGH NURSING HOME ASSOCIATION INC
EIN 59-1104552
Tax Period 201912
Filing Type E
Return Type 990
File View File
Organization Name MARY LEE DEPUGH NURSING HOME ASSOCIATION INC
EIN 59-1104552
Tax Period 201812
Filing Type E
Return Type 990
File View File
Organization Name MARY LEE DEPUGH NURSING HOME ASSOCIATION INC
EIN 59-1104552
Tax Period 201612
Filing Type E
Return Type 990
File View File
Organization Name MARY LEE DEPUGH NURSING HOME ASSOCIATION INC
EIN 59-1104552
Tax Period 201512
Filing Type E
Return Type 990
File View File

Date of last update: 06 Feb 2025

Sources: Florida Department of State