| Entity Name: | ATLANTIC HEALTHCARE CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Profit Corporation |
| Status: | Inactive |
| Date Filed: | 27 May 2005 (20 years ago) |
| Date of dissolution: | 12 Jan 2016 (9 years ago) |
| Last Event: | WITHDRAWAL |
| Event Date Filed: | 12 Jan 2016 (9 years ago) |
| Document Number: | F05000003168 |
| FEI/EIN Number | 52-2514811 |
| Address: | 7150 COLUMBIA GATEWAY DRIVE, SUITE J, COLUMBIA, MD 21046 |
| Mail Address: | 7150 COLUMBIA GATEWAY DRIVE, SUITE J, COLUMBIA, MD 21046 |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346227055 | 2005-12-23 | 2014-07-16 | 3663 15TH AVENUE, VERO BEACH, FL, 32960, US | 3663 15TH AVENUE, VERO BEACH, FL, 32960, US | |||||||||||||||||||||||||
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| Phone | +1 772-567-2552 |
| Fax | 7725678929 |
Authorized person
| Name | MR. BRIAN REYNOLDS |
| Role | CEO |
| Phone | 4105138738 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF1573096 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 211524 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| NICHOLSON, TIMOTHY | Director | 7150 COLUMBIA GATEWAY DRIVE, COLUMBIA, MD 21046 |
| Name | Role | Address |
|---|---|---|
| POOLE, JOHN | President | 7150 COLUMBIA GATEWAY DRIVE, COLUMBIA, MD 21046 |
| Name | Role | Address |
|---|---|---|
| FALLON, JOHN | Secretary | 7150 COLUMBIA GATEWAY DRIVE, COLUMBIA, MD 21046 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G11000067289 | ATLANTIC HEALTHCARE CENTER | EXPIRED | 2011-07-05 | 2016-12-31 | No data | 7150 COLUMBIA GATEWAY DRIVE,, SUITE J, COLUMBIA, MD, 21046 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| WITHDRAWAL | 2016-01-12 | No data | No data |
| REGISTERED AGENT CHANGED | 2016-01-12 | REGISTERED AGENT REVOKED | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-04-12 | 7150 COLUMBIA GATEWAY DRIVE, SUITE J, COLUMBIA, MD 21046 | No data |
| CHANGE OF MAILING ADDRESS | 2013-04-12 | 7150 COLUMBIA GATEWAY DRIVE, SUITE J, COLUMBIA, MD 21046 | No data |
| Name | Date |
|---|---|
| Withdrawal | 2016-01-12 |
| ANNUAL REPORT | 2015-03-12 |
| ANNUAL REPORT | 2014-04-18 |
| ANNUAL REPORT | 2013-04-12 |
| ANNUAL REPORT | 2012-04-05 |
| ANNUAL REPORT | 2011-01-05 |
| ANNUAL REPORT | 2010-01-11 |
| ANNUAL REPORT | 2009-02-05 |
| ANNUAL REPORT | 2008-04-30 |
| ANNUAL REPORT | 2007-01-23 |
Date of last update: 04 Jan 2025
Sources: Florida Department of State
