| Entity Name: | SENIOR HEALTH - FIRST COAST, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 30 Nov 2000 (24 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 22 Feb 2016 (9 years ago) |
| Document Number: | L00000014720 |
| FEI/EIN Number | 36-4403588 |
| Address: | 1665 Palm Beach Lakes Blvd., Suite 400, West Palm Beach, FL, 33401, US |
| Mail Address: | 1665 Palm Beach Lakes Blvd., Suite 400, West Palm Beach, FL, 33401, US |
| ZIP code: | 33401 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932103637 | 2005-06-09 | 2012-10-05 | 1675 PALM BEACH LAKES BLVD, SUITE 900, WEST PALM BEACH, FL, 33401, US | 7723 JASPER AVE, JACKSONVILLE, FL, 322117719, US | |||||||||||||||||||||||||||||
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| Phone | +1 661-801-7600 |
| Fax | 4143684213 |
| Phone | +1 904-725-8044 |
| Fax | 9047213193 |
Authorized person
| Name | HOWARD DILLON JAFFE |
| Role | PRESIDENT |
| Phone | 2153466454 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF1150096 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 022783800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| Jaffe Howard | Manager | 1665 Palm Beach Lakes Blvd., West Palm Beach, FL, 33401 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G08263700074 | FIRST COAST HEALTH AND REHABILITATION CENTER | ACTIVE | 2008-09-19 | 2028-12-31 | No data | 7723 JASPER AVENUE, JACKSONVILLE, FL, 32211 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-06 | 1665 Palm Beach Lakes Blvd., Suite 400, West Palm Beach, FL 33401 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-06 | 1665 Palm Beach Lakes Blvd., Suite 400, West Palm Beach, FL 33401 | No data |
| LC STMNT OF RA/RO CHG | 2016-02-22 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-02-22 | CT CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-02-22 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-06 |
| ANNUAL REPORT | 2023-03-06 |
| ANNUAL REPORT | 2022-03-25 |
| AMENDED ANNUAL REPORT | 2021-06-15 |
| ANNUAL REPORT | 2021-04-13 |
| ANNUAL REPORT | 2020-04-24 |
| ANNUAL REPORT | 2019-03-29 |
| ANNUAL REPORT | 2018-04-10 |
| ANNUAL REPORT | 2017-04-13 |
| ANNUAL REPORT | 2016-04-29 |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DELIVERY ORDER | AWARD | VA573B0012 | 2010-09-21 | 2012-12-31 | 2012-12-31 | |||||||||||||||||||||||||
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| Obligated Amount | 172161.00 |
| Current Award Amount | 172161.00 |
| Potential Award Amount | 172161.00 |
Description
| Title | COMMUNITY NURSING HOME 01/01/2008 THRU 12/31/2012 |
| NAICS Code | 623110: NURSING CARE FACILITIES |
| Product and Service Codes | Q402: NURSING HOME CARE CONTRACTS |
Recipient Details
| Recipient | SENIOR HEALTH - FIRST COAST, LLC |
| UEI | NF53DDJ8KLT7 |
| Recipient Address | 7723 JASPER AVE, JACKSONVILLE, DUVAL, FLORIDA, 322117719, UNITED STATES |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
