| Entity Name: | OKEECHOBEE COUNCIL ON AGING, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 13 Jun 1974 (51 years ago) |
| Document Number: | 729935 |
| FEI/EIN Number | 591544835 |
| Address: | 230 S BARFIELD HWY, PAHOKEE, FL, 33476-1834, US |
| Mail Address: | 230 S BARFIELD HWY, PAHOKEE, FL, 33476-1834, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982605085 | 2005-08-10 | 2013-01-22 | 1311 SW 16TH ST, GAINESVILLE, FL, 326081128, US | 230 S BARFIELD HWY, PAHOKEE, FL, 334761834, US | |||||||||||||||||||||||||||||
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| Phone | +1 352-376-8821 |
| Fax | 3523763654 |
| Phone | +1 561-924-5561 |
| Fax | 5619249466 |
Authorized person
| Name | MR. EDWARD W HURT |
| Role | CHIEF FINANCIAL OFFICER |
| Phone | 3523768821 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF1172096 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 020320300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SHIMBERG ROBERT ESQ | Agent | HILL, WARD, HENDERSON, TAMPA, FL, 33602 |
| Name | Role | Address |
|---|---|---|
| Bohlen Regina | Director | P.O. BOX 141, PAHOKEE, FL, 33476 |
| BIGGS ALLIE | Director | 1547 REV. JESSE BIGGS BLVD, PAHOKEE, FL, 33476 |
| BANKS HIKEEM | Director | 2021 SW PROVIDENCE PLACE, PORT ST. LUCIE, FL, 34953 |
| BLEVINS JOHNNIE | Director | 969 SW 39TH LANE, OKEECHOBEE, FL, 34974 |
| Name | Role | Address |
|---|---|---|
| HURT EDWARD W | Chief Executive Officer | 100 SW 75TH STREET, GAINESVILLE, FL, 326075776 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G02339900030 | GLADES HEALTH CARE CENTER | ACTIVE | 2002-12-05 | 2027-12-31 | No data | 230 SOUTH BARFIELD HIGHWAY, PAHOKEE, FL, 33476 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2001-10-18 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2001-09-21 | No data | No data |
| AMENDMENT | 1990-09-10 | No data | No data |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
