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  5. AVOW HOSPICE, INC.

AVOW HOSPICE, INC. - Florida Company Profile

Company Details

Entity Name: AVOW HOSPICE, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 05 Apr 1982 (43 years ago)
Last Event: AMENDMENT
Event Date Filed: 13 Nov 2015 (9 years ago)
Document Number: 762720
FEI/EIN Number 592201250

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 1095 WHIPPOORWILL LN., NAPLES, FL, 34105, US
Mail Address: 1095 WHIPPOORWILL LN., NAPLES, FL, 34105, US
ZIP code: 34105
County: Collier
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1003872276 2006-04-25 2023-03-10 1205 WHIPPOORWILL LN, NAPLES, FL, 341055028, US 1095 WHIPPOORWILL LN, NAPLES, FL, 341053847, US

Contacts
Phone +1 239-304-1600
Fax 2392805998
Phone +1 239-261-4404

Authorized person
Name MS. PHYLLIS HALL
Role CFO
Phone 2392614404

Taxonomy
Taxonomy Code 251G00000X - Community Based Hospice Care Agency
License Number 5022096
State FL
Is Primary Yes

Other Provider Identifiers
Issuer BLUE CROSS BLUE SHIELD #
Number U02
State FL
Issuer MEDICAID
Number 087537600
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AVOW HOSPICE WELFARE PLAN 2014 592201250 2015-07-28 AVOW HOSPICE 126
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2004-11-01
Business code 621420
Sponsor’s telephone number 2392614404
Plan sponsor’s mailing address 1095 WHIPOORWILL LANE, NAPLES, FL, 341053847
Plan sponsor’s address AVOW HOSPICE, 1095 WHIPOORWILL LANE, NAPLES, FL, 341053847

Number of participants as of the end of the plan year
Active participants 120
Retired or separated participants receiving benefits 6
Other retired or separated participants entitled to future benefits 0
AVOW HOSPICE WELFARE PLAN 2013 592201250 2014-09-03 AVOW HOSPICE 138
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2004-11-01
Business code 621420
Sponsor’s telephone number 2392614404
Plan sponsor’s mailing address 1095 WHIPOORWILL LANE, NAPLES, FL, 341053847
Plan sponsor’s address AVOW HOSPICE, 1095 WHIPOORWILL LANE, NAPLES, FL, 341053847

Number of participants as of the end of the plan year
Active participants 136
Retired or separated participants receiving benefits 4
AVOW HOSPICE WELFARE PLAN 2012 592201250 2013-07-31 AVOW HOSPICE 141
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2004-11-01
Business code 621420
Sponsor’s telephone number 2392614404
Plan sponsor’s mailing address 1095 WHIPOORWILL LANE, NAPLES, FL, 341053847
Plan sponsor’s address AVOW HOSPICE, 1095 WHIPOORWILL LANE, NAPLES, FL, 341053847

Number of participants as of the end of the plan year
Active participants 144
Retired or separated participants receiving benefits 9

Signature of
Role Plan administrator
Date 2013-07-31
Name of individual signing KAREN ROLLINS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-31
Name of individual signing KAREN ROLLINS
Valid signature Filed with authorized/valid electronic signature
AVOW HOSPICE WELFARE PLAN 2011 592201250 2012-07-31 AVOW HOSPICE 120
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2004-11-01
Business code 621420
Sponsor’s telephone number 2392614404
Plan sponsor’s mailing address 1095 WHIPOORWILL LANE, NAPLES, FL, 341053847
Plan sponsor’s address AVOW HOSPICE, 1095 WHIPOORWILL LANE, NAPLES, FL, 341053847

Plan administrator’s name and address
Administrator’s EIN 592201250
Plan administrator’s name AVOW HOSPICE
Plan administrator’s address 1095 WHIPOORWILL LANE, NAPLES, FL, 341053847
Administrator’s telephone number 2392614404

Number of participants as of the end of the plan year
Active participants 132
Retired or separated participants receiving benefits 5

Signature of
Role Plan administrator
Date 2012-07-31
Name of individual signing KAREN ROLLINS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-31
Name of individual signing KAREN ROLLINS
Valid signature Filed with authorized/valid electronic signature
AVOW HOSPICE WELFARE PLAN 2011 592201250 2012-07-31 AVOW HOSPICE 137
Three-digit plan number (PN) 502
Effective date of plan 2004-11-01
Business code 621420
Sponsor’s telephone number 2392614404
Plan sponsor’s mailing address 1095 WHIPOORWILL LANE, NAPLES, FL, 341053847
Plan sponsor’s address AVOW HOSPICE, 1095 WHIPOORWILL LANE, NAPLES, FL, 341053847

Plan administrator’s name and address
Administrator’s EIN 592201250
Plan administrator’s name AVOW HOSPICE
Plan administrator’s address 1095 WHIPOORWILL LANE, NAPLES, FL, 341053847
Administrator’s telephone number 2392614404

Signature of
Role Plan administrator
Date 2012-07-31
Name of individual signing KAREN ROLLINS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-31
Name of individual signing KAREN ROLLINS
Valid signature Filed with authorized/valid electronic signature
AVOW HOSPICE, INC. TAX DEFERRED ANNUITY PLAN 2009 592201250 2011-05-27 AVOW HOSPICE, INC. 267
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1987-06-01
Business code 623000
Sponsor’s telephone number 2392614404
Plan sponsor’s mailing address 1095 WHIPPOORWILL LANE, NAPLES, FL, 34105
Plan sponsor’s address AVOW HOSPICE, INC., 1095 WHIPPOORWILL LANE, NAPLES, FL, 34105

Plan administrator’s name and address
Administrator’s EIN 592201250
Plan administrator’s name AVOW HOSPICE, INC.
Plan administrator’s address 1095 WHIPPOORWILL LANE, NAPLES, FL, 34105
Administrator’s telephone number 2392614404

Number of participants as of the end of the plan year
Active participants 164
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 114
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 229
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 8

Signature of
Role Plan administrator
Date 2011-05-27
Name of individual signing VIVIAN SEELY-TROIANO
Valid signature Filed with authorized/valid electronic signature
AVOW HOSPICE, INC. TAX DEFERRED ANNUITY PLAN 2009 592201250 2010-10-14 AVOW HOSPICE, INC. 267
Three-digit plan number (PN) 002
Effective date of plan 1987-06-01
Business code 623000
Sponsor’s telephone number 2392614404
Plan sponsor’s mailing address 1095 WHIPPOORWILL LANE, NAPLES, FL, 34105
Plan sponsor’s address AVOW HOSPICE, INC., 1095 WHIPPOORWILL LANE, NAPLES, FL, 34105

Plan administrator’s name and address
Administrator’s EIN 592201250
Plan administrator’s name AVOW HOSPICE, INC.
Plan administrator’s address 1095 WHIPPOORWILL LANE, NAPLES, FL, 34105
Administrator’s telephone number 2392614404

Number of participants as of the end of the plan year
Active participants 164
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 114
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 229
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 8

Signature of
Role Plan administrator
Date 2010-10-14
Name of individual signing VIVIAN SEELY-TROIANO
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
HALL PHYLLIS Chief Financial Officer 1095 WHIPPOORWILL LN., NAPLES, FL, 34105
ROA JAYSEN President 1095 WHIPPOORWILL LN., NAPLES, FL, 34105
ROA JAYSEN Chief Executive Officer 1095 WHIPPOORWILL LN., NAPLES, FL, 34105
Lanz Gerald Director 1095 WHIPPOORWILL LN., NAPLES, FL, 34105
Gatian Rebecca Chie 1095 WHIPPOORWILL LN., NAPLES, FL, 34105
Ervin Kerri Chie 1095 WHIPPOORWILL LN., NAPLES, FL, 34105
Gersch Darren Treasurer 1095 WHIPPOORWILL LN., NAPLES, FL, 34105
ROA JAYSEN Agent 1095 WHIPPOORWILL LN., NAPLES, FL, 34105

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G10000076410 AVOW CARE SERVICES EXPIRED 2010-08-19 2015-12-31 - 1095 WHIPPOORWILL LANE, NAPLES, FL, 34105

Events

Event Type Filed Date Value Description
AMENDED AND RESTATEDARTICLES 2016-02-02 - -
AMENDMENT 2015-11-13 - -
REGISTERED AGENT NAME CHANGED 2015-11-12 ROA, JAYSEN -
AMENDED AND RESTATEDARTICLES/NAME CHANGE 2007-09-10 AVOW HOSPICE, INC. -
CHANGE OF MAILING ADDRESS 2001-01-30 1095 WHIPPOORWILL LN., NAPLES, FL 34105 -
MERGER 2000-04-20 - CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 700000028807
REGISTERED AGENT ADDRESS CHANGED 1997-01-30 1095 WHIPPOORWILL LN., NAPLES, FL 34105 -
CHANGE OF PRINCIPAL ADDRESS 1997-01-30 1095 WHIPPOORWILL LN., NAPLES, FL 34105 -

Documents

Name Date
ANNUAL REPORT 2024-04-18
ANNUAL REPORT 2023-04-25
ANNUAL REPORT 2022-04-27
ANNUAL REPORT 2021-04-27
ANNUAL REPORT 2020-05-20
ANNUAL REPORT 2019-04-25
ANNUAL REPORT 2018-01-02
ANNUAL REPORT 2017-03-31
ANNUAL REPORT 2016-03-18
ANNUAL REPORT 2015-03-05

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
59-2201250 Corporation Unconditional Exemption 1095 WHIPPOORWILL LN, NAPLES, FL, 34105-3800 1983-06
In Care of Name % JAYSEN F ROA
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Organization that receives a substantial part of its support from a governmental unit or the general public 170(b)(1)(A)(vi)
Tax Period 2023-12
Asset 10,000,000 to 49,999,999
Income 10,000,000 to 49,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 34439083
Income Amount 31547863
Form 990 Revenue Amount 31508929
National Taxonomy of Exempt Entities -
Sort Name -

Publication 78 Data
Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name AVOW HOSPICE INC
EIN 59-2201250
Tax Period 202212
Filing Type E
Return Type 990
File View File
Organization Name AVOW HOSPICE INC
EIN 59-2201250
Tax Period 202112
Filing Type E
Return Type 990
File View File
Organization Name AVOW HOSPICE INC
EIN 59-2201250
Tax Period 201912
Filing Type E
Return Type 990
File View File
Organization Name AVOW HOSPICE INC
EIN 59-2201250
Tax Period 201812
Filing Type E
Return Type 990
File View File
Organization Name AVOW HOSPICE INC
EIN 59-2201250
Tax Period 201612
Filing Type E
Return Type 990
File View File
Organization Name AVOW HOSPICE INC
EIN 59-2201250
Tax Period 201512
Filing Type E
Return Type 990
File View File

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ROA JAYSEN

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AVOW CARE SERVICES, INC. - Active
Domestic Non-Profit (2010 )
AVOW CARE SERVICES, INC. - Active
Domestic Non-Profit (2010 )

Lanz Gerald

AVOW, INC. - Active
Domestic Non-Profit (2014 )
AVOW REAL ESTATE, INC. - Active
Domestic Non-Profit (2016 )
AVOW CARE SERVICES, INC. - Active
Domestic Non-Profit (2010 )

Gatian Rebecca

AVOW, INC. - Active
Domestic Non-Profit (2014 )
AVOW CARE SERVICES, INC. - Active
Domestic Non-Profit (2010 )

Ervin Kerri

AVOW, INC. - Active
Domestic Non-Profit (2014 )
AVOW REAL ESTATE, INC. - Active
Domestic Non-Profit (2016 )
PALMETTO RIDGE TOUCHDOWN CLUB, INC. - Inactive
Domestic Non-Profit (2004 - 2015)
AVOW CARE SERVICES, INC. - Active
Domestic Non-Profit (2010 )

Gersch Darren

AVOW, INC. - Active
Domestic Non-Profit (2014 )
AVOW FOUNDATION, INC. - Active
Domestic Non-Profit (2014 )
AVOW CARE SERVICES, INC. - Active
Domestic Non-Profit (2010 )

Companies related by address

No other companies in our directory share the same address as AVOW HOSPICE, INC.

Date of last update: 01 Mar 2025

Sources: Florida Department of State

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