| Entity Name: | RUSHAN CORPORATION |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 29 Sep 1986 (38 years ago) |
| Document Number: | J35419 |
| FEI/EIN Number | 592810646 |
| Mail Address: | 5544 SWANNER RD, MILTON, FL, 32570 |
| Address: | 5544 SWANNER RD, MILTON, FL, 32570, US |
| ZIP code: | 32570 |
| County: | Santa Rosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073773081 | 2008-06-12 | 2008-06-12 | 5544 SWANNER RD, MILTON, FL, 325704069, US | 5544 SWANNER RD, MILTON, FL, 325704069, US | |||||||||||||||||||||||||||||||||||
|
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| Phone | +1 850-623-6550 |
Authorized person
| Name | MRS. TERRY STACEY |
| Role | ADMINISTRATOR |
| Phone | 8506236550 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | ALF 9519 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 140175100 |
| State | FL |
| Issuer | MEDICAID |
| Number | 689445300 |
| State | FL |
| Issuer | MEDICAID |
| Number | 678441100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HARRIS, RUSSELL LYNN | Agent | 5544 SWANNER RD, MILTON, FL, 32570 |
| Name | Role | Address |
|---|---|---|
| HARRIS, BRITTANY | Vice President | 5544 SWANNER ROAD, MILTON, FL, 32570 |
| Name | Role | Address |
|---|---|---|
| HARRIS, RUSSELL LYNN | President | 5544 SWANNER ROAD, MILTON, FL, 32570 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000041234 | BERRYHILL MANOR RETIREMENT CENTER | ACTIVE | 2022-03-31 | 2027-12-31 | No data | 5544 SWANNER RD, MILTON, FL, 32570 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 1993-11-15 | No data | No data |
| REINSTATEMENT | 1989-01-24 | No data | No data |
| INVOLUNTARILY DISSOLVED | 1988-11-04 | No data | No data |
Date of last update: 03 Jan 2025
Sources: Florida Department of State
