| Entity Name: | CHANGE OF PACE RETIREMENT CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 13 Apr 1987 (38 years ago) |
| Document Number: | J67776 |
| FEI/EIN Number | 59-2847600 |
| Address: | 1715 E SILVER SPGS BLVD, OCALA, FL, 34470 |
| Mail Address: | 1715 E SILVER SPGS BLVD, OCALA, FL, 34470 |
| ZIP code: | 34470 |
| County: | Marion |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669639274 | 2008-05-21 | 2008-05-21 | 1715 E SILVER SPRINGS BLVD, OCALA, FL, 344706922, US | 1715 E SILVER SPRINGS BLVD, OCALA, FL, 344706922, US | |||||||||||||||||||||||||
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| Phone | +1 352-629-8990 |
| Fax | 3526298990 |
Authorized person
| Name | MRS. CYNTHIA JEAN OBRIEN |
| Role | PRES ADMINISTRATOR |
| Phone | 3526298990 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL53 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 140253600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| O'BRIEN, CYNTHIA J. | Agent | 3320 S.E. 2nd St., OCALA, FL, 34471 |
| Name | Role | Address |
|---|---|---|
| O'BRIEN, CYNTHIA J. | President | 3320 S.E. 2nd St., OCALA, FL, 34471 |
| Name | Role | Address |
|---|---|---|
| O'BRIEN, CYNTHIA J. | Director | 3320 S.E. 2nd St., OCALA, FL, 34471 |
| Name | Role | Address |
|---|---|---|
| O'Brien Cynthia J | Secretary | 3320 S.E. 2nd St., Ocala, FL, 34471 |
| Name | Role | Address |
|---|---|---|
| O'Brien Cynthia T | Treasurer | 3320 S.E. 2nd St., Oala, FL, 34471 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2022-12-20 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| REINSTATEMENT | 2020-05-13 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| REINSTATEMENT | 2011-12-07 | No data | No data |
| PENDING REINSTATEMENT | 2011-12-07 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
