| Entity Name: | MIRACLE HILL NURSING AND REHABILITATION CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Not For Profit Corporation |
| Status: | Active |
| Date Filed: | 03 Oct 1968 (56 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 11 Jun 2010 (15 years ago) |
| Document Number: | 715374 |
| FEI/EIN Number | 59-1275598 |
| Address: | 1329 ABRAHAM STREET, TALLAHASSEE, FL 32304 |
| Mail Address: | 1329 ABRAHAM STREET, TALLAHASSEE, FL 32304 |
| ZIP code: | 32304 |
| County: | Leon |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780161000 | 2018-07-20 | 2021-10-08 | 1329 ABRAHAM ST, TALLAHASSEE, FL, 323041907, US | 1329 ABRAHAM ST, TALLAHASSEE, FL, 323041907, US | |||||||||||||||||||||||||||||
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| Phone | +1 850-224-8486 |
| Fax | 8502248815 |
Authorized person
| Name | AIDIA KIRKSEY |
| Role | CONTROLLER |
| Phone | 8506619779 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QR0400X - Rehabilitation Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 261QR0401X - Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | SNF1354096 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Burney, Chris A, President | Agent | 1329 ABRAHAM STREET, TALLAHASSEE, FL 32304 |
| Name | Role | Address |
|---|---|---|
| Burney, Chris A, Elder Dr. | President | 5820 North Monroe ST., Tallahassee, FL 32303 |
| Name | Role | Address |
|---|---|---|
| Chester, James H, ELDER DR. | Director | 1730 Echo Lake Dr., West Palm Beach, FL 33407 |
| Williams, Ernest, Elder | Director | 201 West Leonard Street, Pensacola, FL 32501-1413 |
| Smith, Frederick, Elder | Director | 7516 Saint Joseph ST, Milton, FL 32583 |
| Price, Terry, Elder Dr. | Director | 3166 Ferns DR, Tallahassee, FL 32309 |
| Ford, Alvin, Elder | Director | 9823 Kinfolks Loop, Tallahassee, FL 32317 |
| Name | Role | Address |
|---|---|---|
| Osborne, Rodney | Elder | 1329 ABRAHAM STREET, TALLAHASSEE, FL 32304 |
| Name | Role | Address |
|---|---|---|
| Israel, Michael T, Elder | Secretary | 899 Collier Blvd., St. Augustine, FL 32084 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000087870 | MIRACLE HILL OUTPATIENT REHABILITATIVE SERVICES | ACTIVE | 2024-07-23 | 2029-12-31 | No data | 1329 ABRAHAM STREET, TALLAHASSEE, FL, 32304 |
| G24000084275 | MIRACLE HILL OUTPATIENT REHABILITATATIVE SERVICES | ACTIVE | 2024-07-15 | 2029-12-31 | No data | 1329 ABRAHAM STREET, TALLAHASSEE, FL |
| G18000092613 | MIRACLE HILL OUTPATIENT REHABILITATIVE SERVICES | EXPIRED | 2018-08-20 | 2023-12-31 | No data | 13229 ABRAHAM STREET, TALLAHASSEE, FL, 32304 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-06-23 | Burney, Chris A, President | No data |
| NAME CHANGE AMENDMENT | 2010-06-11 | MIRACLE HILL NURSING AND REHABILITATION CENTER, INC. | No data |
| AMENDMENT | 2006-11-21 | No data | No data |
| AMENDMENT | 2006-08-25 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2003-05-01 | 1329 ABRAHAM STREET, TALLAHASSEE, FL 32304 | No data |
| RESTATED ARTICLES AND NAME CHANGE | 1994-06-30 | MIRACLE HILL NURSING AND CONVALESCENT CENTER, INC. | No data |
| EVENT CONVERTED TO NOTES | 1990-04-04 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J18000198523 | TERMINATED | 1000000781809 | LEON | 2018-05-17 | 2028-05-23 | $ 2,392.96 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, TALLAHASSEE SERVICE CENTER, 2639 N MONROE ST STE 100B, TALLAHASSEE FL323034045 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-08-09 |
| AMENDED ANNUAL REPORT | 2023-06-23 |
| AMENDED ANNUAL REPORT | 2023-01-04 |
| ANNUAL REPORT | 2023-01-03 |
| AMENDED ANNUAL REPORT | 2022-12-06 |
| AMENDED ANNUAL REPORT | 2022-11-03 |
| ANNUAL REPORT | 2022-04-22 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-04-06 |
| ANNUAL REPORT | 2019-05-01 |
Date of last update: 06 Feb 2025
Sources: Florida Department of State
