| Entity Name: | VISITING NURSE ASSOCIATION OF INDIAN RIVER COUNTY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 28 Apr 1975 (50 years ago) |
| Document Number: | 732581 |
| FEI/EIN Number | 591645497 |
| Address: | 445 24th Street, VERO BEACH, FL, 32960, US |
| Mail Address: | 445 24th Street, VERO BEACH, FL, 32960, US |
| ZIP code: | 32960 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306843768 | 2005-06-30 | 2023-06-19 | 445 24TH ST STE 300, VERO BEACH, FL, 329607502, US | 445 24TH ST STE 300, VERO BEACH, FL, 329607502, US | |||||||||||||||||||||||||||||||
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| Phone | +1 772-567-5551 |
| Fax | 7725691444 |
Authorized person
| Name | DANIEL BACH |
| Role | CFO |
| Phone | 7725675551 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | HHA21276095 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | LICENSE |
| Number | HHA21276095 |
| State | FL |
| Issuer | MEDICARE PTAN |
| Number | 107134 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| EMMONS REBECCA F | Agent | 2101 Indian River Boulevard Suite 200, VERO BEACH, FL, 32960 |
| Name | Role | Address |
|---|---|---|
| Stengel William | Chairman | 161 BERMUDA BAY LANE, VERO BEACH, FL, 32963 |
| Name | Role | Address |
|---|---|---|
| FIELDS LUNDY S | Chief Executive Officer | 1110 35TH LANE, VERO BEACH, FL, 32960 |
| Name | Role | Address |
|---|---|---|
| Weisbaum Jack | Treasurer | 109 Springline Drive, Vero Beach, FL, 32963 |
| Name | Role | Address |
|---|---|---|
| Hendrix Kathy | Director | 23 Sailfish Road, Vero Beach, FL, 32960 |
| Name | Role | Address |
|---|---|---|
| Perry Angelia | Secretary | 4505 48th Ave, VERO BEACH, FL, 32967 |
| Name | Role | Address |
|---|---|---|
| Rodgers Susan P | Vice Chairman | 700 Beach Road, Vero Beach, FL, 32963 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G11000043831 | NIGHTINGALE PRIVATE DUTY NURSING | EXPIRED | 2011-05-09 | 2016-12-31 | No data | 920 37TH PLACE SUITE 101, VERO BEACH, FL, 32960 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDED AND RESTATEDARTICLES | 2010-05-27 | No data | No data |
| AMENDED AND RESTATEDARTICLES | 1986-01-17 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
