| Entity Name: | GOOD SAMARITAN RETIREMENT HOME, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 25 Sep 1980 (44 years ago) |
| Date of dissolution: | 15 Sep 2006 (18 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 15 Sep 2006 (18 years ago) |
| Document Number: | F00271 |
| FEI/EIN Number | 59-2030908 |
| Address: | 507 SE 1ST AVE, WILLISTON, FL 32696 |
| Mail Address: | 507 SE 1ST AVE, WILLISTON, FL 32696 |
| ZIP code: | 32696 |
| County: | Levy |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821344540 | 2012-07-31 | 2012-07-31 | 507 SE 1ST AVE, WILLISTON, FL, 326962703, US | 507 SE 1ST AVE, WILLISTON, FL, 326962703, US | |||||||||||||||||
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| Phone | +1 904-521-7482 |
Authorized person
| Name | LORNA VICEDA |
| Role | OWNER / ADMINISTRATOR |
| Phone | 9045217482 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | 25 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FUGATE, NORM D. | Agent | 110 N.E. 5TH STREET, WILLISTON, FL 32696 |
| Name | Role | Address |
|---|---|---|
| MARTIN, AURORA | President | 18350 NE 35TH ST, WILLISTON, FL 32696 |
| Name | Role | Address |
|---|---|---|
| MARTIN NOLFE, SHERRY LYN | Vice President | 2081 LAKE TODD CT., APOPKA, FL 32712 |
| Name | Role | Address |
|---|---|---|
| NOLFE, JOHN DAVID | Secretary | 2081 LAKE TODD CT., APOPKA, FL 32712 |
| Name | Role | Address |
|---|---|---|
| MARTIN, ALEXANDER | Treasurer | 18350 NE 35TH ST, WILLISTON, FL 32696 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2000-07-14 | 110 N.E. 5TH STREET, WILLISTON, FL 32696 | No data |
| REGISTERED AGENT NAME CHANGED | 1996-03-21 | FUGATE, NORM D. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 1983-02-02 | 507 SE 1ST AVE, WILLISTON, FL 32696 | No data |
| CHANGE OF MAILING ADDRESS | 1983-02-02 | 507 SE 1ST AVE, WILLISTON, FL 32696 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2005-02-09 |
| ANNUAL REPORT | 2004-04-23 |
| ANNUAL REPORT | 2003-01-21 |
| ANNUAL REPORT | 2002-01-30 |
| ANNUAL REPORT | 2001-04-03 |
| ANNUAL REPORT | 2000-07-14 |
| ANNUAL REPORT | 1999-05-04 |
| ANNUAL REPORT | 1998-03-16 |
| ANNUAL REPORT | 1997-05-02 |
| ANNUAL REPORT | 1996-03-21 |
Date of last update: 05 Feb 2025
Sources: Florida Department of State
