| Entity Name: | GENESIS HEALTH DEVELOPMENT, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 19 Jan 1983 (42 years ago) |
| Document Number: | 766695 |
| FEI/EIN Number | 592249372 |
| Address: | 3599 UNIVERSITY BLVD. SOUTH, JACKSONVILLE, FL, 32216, US |
| Mail Address: | 3599 UNIVERSITY BLVD. SOUTH, JACKSONVILLE, FL, 32216, US |
| ZIP code: | 32216 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528707379 | 2022-05-31 | 2024-09-19 | 3599 UNIVERSITY BLVD S, ATTN MANAGED CARE, JACKSONVILLE, FL, 32216, US | 2616 S HWY 27, CLERMONT, FL, 347116526, US | |||||||||||||||
|
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| Phone | +1 904-345-7291 |
| Phone | +1 352-565-5992 |
Authorized person
| Name | KELLI CAMERON |
| Role | DIRECTOR OF MANGED CARE |
| Phone | 9043457158 |
Taxonomy
| Taxonomy Code | 261QR0400X - Rehabilitation Clinic/Center |
| Is Primary | Yes |
| Name | Role |
|---|---|
| URS AGENTS, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| BAER DOUGLAS M. | President | 3599 UNIVERSITY BLVD. SOUTH, JACKSONVILLE, FL, 32216 |
| Name | Role | Address |
|---|---|---|
| SERKIN HOWARD | Director | 3599 UNIVERSITY BLVD. SOUTH, JACKSONVILLE, FL, 32216 |
| Tabor J. B | Director | 3599 UNIVERSITY BLVD. SOUTH, JACKSONVILLE, FL, 32216 |
| Roberts Kris | Director | 3599 UNIVERSITY BLVD. SOUTH, JACKSONVILLE, FL, 32216 |
| DeRienzo Victor | Director | 3599 UNIVERSITY BLVD. SOUTH, JACKSONVILLE, FL, 32216 |
| Mann Eric | Director | 3599 UNIVERSITY BLVD. SOUTH, JACKSONVILLE, FL, 32216 |
| BAER DOUGLAS M. | Director | 3599 UNIVERSITY BLVD. SOUTH, JACKSONVILLE, FL, 32216 |
| Name | Role | Address |
|---|---|---|
| Roberts Kris | Vice President | 3599 UNIVERSITY BLVD. SOUTH, JACKSONVILLE, FL, 32216 |
| DeRienzo Victor | Vice President | 3599 UNIVERSITY BLVD. SOUTH, JACKSONVILLE, FL, 32216 |
| Name | Role | Address |
|---|---|---|
| BAER DOUGLAS M. | Chairman | 3599 UNIVERSITY BLVD. SOUTH, JACKSONVILLE, FL, 32216 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000066718 | BROOKS REHABILITATION NETWORK | ACTIVE | 2023-05-31 | 2028-12-31 | No data | 3599 UNIVERSITY BLVD, JACKSONVILLE, FL, 32216 |
| G16000025670 | BROOKS REHABILITATION APHASIA CENTER | ACTIVE | 2016-03-10 | 2026-12-31 | No data | 2700 UNIVERSITY BLVD. W. BLDG B, JACKSONVILLE, FL, 32217 |
| G15000053555 | BROOKS REHAB CENTER | ACTIVE | 2015-06-02 | 2025-12-31 | No data | 3599 UNIVERSITY BLVD. S, JACKSONVILLE, FL, 32216 |
| G04303900224 | BROOKS REHABILITATION | ACTIVE | 2004-10-29 | 2029-12-31 | No data | 3599 UNIVERSITY BLVD SOUTH, JACKSONVILLE, FL, 32216 |
| G99008900026 | BROOKS HEALTH DEVELOPMENT | ACTIVE | 1999-01-08 | 2029-12-31 | No data | 3599 UNIVERSITY BLVD SOUTH, JACKSONVILLE, FL, 32216 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDED AND RESTATEDARTICLES/NAME CHANGE | 1998-04-20 | GENESIS HEALTH DEVELOPMENT, INC. | No data |
| NAME CHANGE AMENDMENT | 1995-02-22 | GENESIS COMMUNITY HEALTH SERVICES, INC. | No data |
| NAME CHANGE AMENDMENT | 1994-08-23 | MHS COMMUNITY HEALTH SERVICES, INC. | No data |
| AMENDMENT | 1987-03-20 | No data | No data |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
