| Entity Name: | PLYMOUTH HOME FOR ADULTS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 03 May 1984 (41 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 12 Oct 2007 (17 years ago) |
| Document Number: | H01835 |
| FEI/EIN Number | 59-2401554 |
| Address: | % CARLOS MORALES, 3225 PLYMOUTH STREET, JACKSONVILLE, FL 32205 |
| Mail Address: | % CARLOS MORALES, 3225 PLYMOUTH STREET, JACKSONVILLE, FL 32205 |
| ZIP code: | 32205 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447554910 | 2010-12-27 | 2010-12-27 | 3225 PLYMOUTH ST, JACKSONVILLE, FL, 322056099, US | 3225 PLYMOUTH ST, JACKSONVILLE, FL, 322056099, US | |||||||||||||||||||||||||
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| Phone | +1 904-384-5796 |
| Fax | 9043841061 |
Authorized person
| Name | MR. CARLOS MORALES |
| Role | ADMINISTRATOR |
| Phone | 9043845796 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | 5228 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 140858500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MORALES, CARLOS | Agent | 3225 PLYMOUTH STREET, JACKSONVILLE, FL 32205 |
| Name | Role | Address |
|---|---|---|
| Morales, Alexandra | Secretary | % CARLOS MORALES, 3225 PLYMOUTH STREET JACKSONVILLE, FL 32205 |
| Name | Role | Address |
|---|---|---|
| MORALES, CARLOS | Director | 3225 PLYMOUTH STREET, JACKSONVILLE, FL |
| Name | Role | Address |
|---|---|---|
| MORALES, CARLOS | President | 3225 PLYMOUTH STREET, JACKSONVILLE, FL |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000154338 | PLYMOUTH HOUSE | ACTIVE | 2021-11-18 | 2026-12-31 | No data | 3225 PLYMOUTH STREET, JACKSONVILLE, FL, 32205 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CANCEL ADM DISS/REV | 2007-10-12 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 1991-02-13 | % CARLOS MORALES, 3225 PLYMOUTH STREET, JACKSONVILLE, FL 32205 | No data |
| CHANGE OF MAILING ADDRESS | 1991-02-13 | % CARLOS MORALES, 3225 PLYMOUTH STREET, JACKSONVILLE, FL 32205 | No data |
| REGISTERED AGENT NAME CHANGED | 1986-03-17 | MORALES, CARLOS | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J08000276411 | TERMINATED | 1000000087516 | 14600 241 | 2008-08-07 | 2028-08-20 | $ 3,504.99 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, JACKSONVILLE SERVICE CENTER, 921 N DAVIS ST STE A-250, JACKSONVILLE FL322096804 |
| J09000124932 | TERMINATED | 1000000087514 | 14600 256 | 2008-08-07 | 2029-01-22 | $ 300.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, JACKSONVILLE SERVICE CENTER, 921 N DAVIS ST STE A-250, JACKSONVILLE FL322096804 |
| J07000194590 | TERMINATED | 1000000051603 | 14020 1146 | 2007-06-07 | 2027-06-27 | $ 10,062.92 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, JACKSONVILLE SERVICE CENTER, 921 N DAVIS ST STE 250A, JACKSONVILLE FL322096825 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-05 |
| ANNUAL REPORT | 2023-04-11 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-03-03 |
| ANNUAL REPORT | 2020-06-08 |
| ANNUAL REPORT | 2019-04-12 |
| ANNUAL REPORT | 2018-03-30 |
| ANNUAL REPORT | 2017-04-13 |
| ANNUAL REPORT | 2016-04-23 |
| ANNUAL REPORT | 2015-04-15 |
Date of last update: 04 Feb 2025
Sources: Florida Department of State
