| Entity Name: | JOHN KNOX VILLAGE OF FLORIDA, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Not For Profit Corporation |
| Status: | Active |
| Date Filed: | 06 Feb 1978 (47 years ago) |
| Last Event: | AMENDED AND RESTATED ARTICLES |
| Event Date Filed: | 10 Jul 2024 (7 months ago) |
| Document Number: | 741760 |
| FEI/EIN Number | 59-1800721 |
| Address: | 651 VILLAGE DRIVE, POMPANO BEACH, FL 33060 |
| Mail Address: | 651 VILLAGE DRIVE, POMPANO BEACH, FL 33060 |
| ZIP code: | 33060 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | JOHN KNOX VILLAGE OF FLORIDA, INC., NEW YORK | 568867 | NEW YORK |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790772127 | 2005-09-30 | 2024-11-04 | 830 LAKESIDE CIR, POMPANO BEACH, FL, 330607748, US | 830 LAKESIDE CIR, POMPANO BEACH, FL, 330607748, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 954-783-4090 |
| Fax | 9547834043 |
| Phone | +1 954-783-4000 |
Authorized person
| Name | DOUGLAS FOLSOM |
| Role | CHIEF FINANCIAL OFFICER |
| Phone | 9547834096 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF1258096 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 020376900 |
| State | FL |
| Name | Role |
|---|---|
| GY CORPORATE SERVICES, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| Crissy, Jack | Chairman | 651 Village Drive, Pompano Beach, FL 33060 |
| Name | Role | Address |
|---|---|---|
| BARBERA, SALVATORE | President | 651 Village Drive, Pompano Beach, FL 33060 |
| Name | Role | Address |
|---|---|---|
| BARBERA, SALVATORE | Chief Executive Officer | 651 Village Drive, Pompano Beach, FL 33060 |
| Name | Role | Address |
|---|---|---|
| WILLIAMS, CHUCK | Chief Information Officer | 651 Village Drive, Pompano Beach, FL 33060 |
| Name | Role | Address |
|---|---|---|
| FOLSOM, DOUGLAS | Chief Financial Officer | 651 Village Drive, Pompano Beach, FL 33060 |
| Name | Role | Address |
|---|---|---|
| Clark, Michelle, Dr. | Vice Chairman | 651 VILLAGE DRIVE, POMPANO BEACH, FL 33060 |
| Name | Role | Address |
|---|---|---|
| DeJong, Dirk | Secretary | 651 VILLAGE DRIVE, POMPANO BEACH, FL 33060 |
| Name | Role | Address |
|---|---|---|
| DeJong, Dirk | Treasurer | 651 VILLAGE DRIVE, POMPANO BEACH, FL 33060 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000054556 | WESTLAKE EATERY & BV'S WINE BAR | ACTIVE | 2024-04-24 | 2029-12-31 | No data | 651 SW 6TH STREET, POMPANO BEACH, FL, 33060 |
| G22000026760 | SEAGLASS | ACTIVE | 2022-02-09 | 2027-12-31 | No data | 832 LAKESIDE CIRCLE, POMPANO BEACH, FL, 33060 |
| G20000151640 | THE GLADES GRILL | ACTIVE | 2020-11-30 | 2025-12-31 | No data | 832 LAKESIDE CIRCLE, POMPANO BEACH, FL, 33060 |
| G16000059210 | PALM BISTRO | EXPIRED | 2016-06-15 | 2021-12-31 | No data | JOHN KNOX VILLAGE OF FLORIDA, INC., 700 SW 4TH ST, POMPANY BEACH, FL, 33060 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDED AND RESTATEDARTICLES | 2024-07-10 | No data | No data |
| AMENDMENT | 2022-10-11 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-02-28 | GY CORPORATE SERVICES, INC. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-02-28 | 777 S Flagler Drive, Suite 500E, West Palm Beach, FL 33401 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-03-28 | 651 VILLAGE DRIVE, POMPANO BEACH, FL 33060 | No data |
| CHANGE OF MAILING ADDRESS | 2013-03-28 | 651 VILLAGE DRIVE, POMPANO BEACH, FL 33060 | No data |
| AMENDMENT | 1987-02-13 | No data | No data |
| Name | Date |
|---|---|
| Amended and Restated Articles | 2024-07-10 |
| ANNUAL REPORT | 2024-02-22 |
| AMENDED ANNUAL REPORT | 2023-09-08 |
| ANNUAL REPORT | 2023-04-02 |
| Amendment | 2022-10-11 |
| ANNUAL REPORT | 2022-02-28 |
| ANNUAL REPORT | 2021-03-12 |
| ANNUAL REPORT | 2020-01-14 |
| ANNUAL REPORT | 2019-02-10 |
| AMENDED ANNUAL REPORT | 2018-04-22 |
Date of last update: 05 Feb 2025
Sources: Florida Department of State
