| Entity Name: | CSI PRIVATE DUTY SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Profit |
| Status: | Active |
| Date Filed: | 20 Jul 1998 (27 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 04 Dec 2002 (22 years ago) |
| Document Number: | F98000004112 |
| FEI/EIN Number | 621746253 |
| Address: | 2324 S. CONGRESS AVE., SUITE #2D, PALM SPRINGS, FL, 33406, US |
| Mail Address: | 33 S. State St, Fifth Floor, Chicago, IL, 60603, US |
| ZIP code: | 33406 |
| County: | Palm Beach |
| Place of Formation: | TENNESSEE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851724199 | 2013-08-09 | 2024-10-10 | 33 S STATE ST FL 5, CHICAGO, IL, 606032804, US | 1116 PELICAN BAY DR, SOUTH DAYTONA, FL, 321191381, US | |||||||||||||||||||||||
|
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| Phone | +1 312-762-9999 |
| Phone | +1 386-761-7351 |
| Fax | 3867619923 |
Authorized person
| Name | JOSEPH BONACCORSI |
| Role | CHIEF LEGAL OFFICER, SECRETARY |
| Phone | 3127629999 |
Taxonomy
| Taxonomy Code | 3747A0650X - Attendant Care Provider |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 679650800 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| McGroarty Ryan | Director | 33 S. State St, Chicago, IL, 60603 |
| Bonaccorsi Joseph | Director | 33 S. State St, Chicago, IL, 60603 |
| Name | Role | Address |
|---|---|---|
| Smithberger Raymond | President | 33 S. State St, Chicago, IL, 60603 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G02338900192 | FRIENDS ASSISTING SENIORS & FAMILIES | ACTIVE | 2002-12-04 | 2027-12-31 | No data | 10451 NW 117 AVE, SUITE 110, MIAMI, FL, 33178 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-10-10 | 2324 S. CONGRESS AVE., SUITE #2D, PALM SPRINGS, FL 33406 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-10-10 | 1201 Hays St, Tallahassee, FL 32301 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-10-10 | Corporation Service Company | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-05-22 | 2324 S. CONGRESS AVE., SUITE #2D, PALM SPRINGS, FL 33406 | No data |
| NAME CHANGE AMENDMENT | 2002-12-04 | CSI PRIVATE DUTY SERVICES, INC. | No data |
| REINSTATEMENT | 2000-10-06 | No data | No data |
| REVOKED FOR ANNUAL REPORT | 2000-09-22 | No data | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-10-10 |
| ANNUAL REPORT | 2024-03-08 |
| AMENDED ANNUAL REPORT | 2023-05-22 |
| ANNUAL REPORT | 2023-02-17 |
| ANNUAL REPORT | 2022-03-14 |
| ANNUAL REPORT | 2021-03-05 |
| AMENDED ANNUAL REPORT | 2020-07-15 |
| ANNUAL REPORT | 2020-03-23 |
| ANNUAL REPORT | 2019-04-08 |
| ANNUAL REPORT | 2018-03-12 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
