| Entity Name: | FAMILY BOARDING HOME, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 30 Jan 1984 (41 years ago) |
| Document Number: | G90275 |
| FEI/EIN Number | 592412614 |
| Address: | 1120 SW 19TH AVE, MIAMI, FL, 33135 |
| Mail Address: | 1120 SW 19TH AVE, MIAMI, FL, 33135 |
| ZIP code: | 33135 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336447176 | 2011-03-03 | 2011-03-03 | 1800 SW 11 TERRACE, MIAMI, FL, 33135, US | 1800 SW 11TH TER, MIAMI, FL, 331355114, US | |||||||||||||||||||||||||
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| Phone | +1 305-643-2571 |
| Fax | 3056440091 |
Authorized person
| Name | MR. RUBEN CORTEGUERA |
| Role | ASSISTED LIVING FACILITY ADM. |
| Phone | 3056432571 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL5438 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 140878000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KUKER HOWARD L | Agent | 9200 SOUTH DADELAND BLVD., STE 508, MIAMI, FL, 33156 |
| Name | Role | Address |
|---|---|---|
| GONZALEZ LEONOR | Director | 1120 SW 19TH AVE, MIAMI, FL, 33135 |
| Name | Role | Address |
|---|---|---|
| GONZALEZ LEONOR | President | 1120 SW 19TH AVE, MIAMI, FL, 33135 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000028008 | CORNER HOUSE ALF | EXPIRED | 2013-03-21 | 2018-12-31 | No data | 1120 SW 19 AVE, MIAMI, FL, 33135 |
| G12000035485 | ARCADIA MANOR ALF | EXPIRED | 2012-04-13 | 2017-12-31 | No data | 1026 SW 19 AVE, MIAMI, FL, 33135 |
| G12000035487 | ARCADIA MANOR SOUTH ALF | EXPIRED | 2012-04-13 | 2017-12-31 | No data | 1144 SW 19 AVE, MIAMI, FL, 33135 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| AMENDMENT | 2011-12-05 | No data | No data |
| REINSTATEMENT | 2011-02-08 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| REINSTATEMENT | 1990-03-20 | No data | No data |
| INVOLUNTARILY DISSOLVED | 1988-11-04 | No data | No data |
| REINSTATEMENT | 1986-08-12 | No data | No data |
| INVOLUNTARILY DISSOLVED | 1985-11-01 | No data | No data |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
