| Entity Name: | THE HOSPICE OF MARTIN & ST. LUCIE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 23 Dec 1981 (43 years ago) |
| Document Number: | 761214 |
| FEI/EIN Number | 592171740 |
| Address: | 1201 SE INDIAN ST., STUART, FL, 34997, US |
| Mail Address: | 1201 SE INDIAN ST., STUART, FL, 34997, US |
| ZIP code: | 34997 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1699886184 | 2006-08-31 | 2019-08-13 | 1201 SE INDIAN ST, STUART, FL, 34997, US | 1201 SE INDIAN ST, STUART, FL, 349975688, US | |||||||||||||||||||||||||
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| Phone | +1 772-403-4500 |
| Fax | 7727818723 |
Authorized person
| Name | MRS. JACKIE KENDRICK |
| Role | CEO |
| Phone | 7724034500 |
Taxonomy
| Taxonomy Code | 251G00000X - Community Based Hospice Care Agency |
| License Number | 50210961 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 087514700 |
| State | FL |
| Name | Role |
|---|---|
| FOX MCCLUSKEY BUSH ROBISON, PLLC | Agent |
| Name | Role | Address |
|---|---|---|
| Hoffman Scott | Trustee | 12176 Riverbend Ln, Port St Lucie, FL, 349846426 |
| Haisley Jimmie Anne | Trustee | 3015 Okeechobee Rd, Ft Pierce, FL, 349474616 |
| Name | Role | Address |
|---|---|---|
| Bender Ewald W | Chairman | 6764 SE Pacific Drive, Stuart, FL, 349978690 |
| Name | Role | Address |
|---|---|---|
| Beville Glenn | Chief Financial Officer | 8054 Sonoma Pacific Drive, Columbus, GA, 31909 |
| Name | Role | Address |
|---|---|---|
| Kendrick Jackie | President | 4943 Bald Cypress Trail, Fort Pierce, FL, 34951 |
| Name | Role | Address |
|---|---|---|
| Martello Carl | Cont | 2650 SE Hamden Road, Port saint Lucie, FL, 34952 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G05220900411 | TREASURE COAST HOSPICES, MARTIN | ACTIVE | 2005-08-08 | 2026-12-31 | No data | 1201 SE INDIAN ST, STUART, FL, 34997 |
| G05171900360 | TREASURE COAST HOSPICE OF MARTIN | ACTIVE | 2005-06-20 | 2026-12-31 | No data | 1201 SE INDIAN ST, STUART, FL, 34997 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| RESTATED ARTICLES | 2004-10-01 | No data | No data |
| NAME CHANGE AMENDMENT | 1995-08-07 | THE HOSPICE OF MARTIN & ST. LUCIE, INC. | No data |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
