Entity Name: | SENIOR HEALTH - CONCORDIA, 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: | L00000014721 |
FEI/EIN Number | 36-4403589 |
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 | |||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1962406652 | 2005-06-09 | 2022-07-21 | 1675 PALM BEACH LAKES BLVD, SUITE 900, WEST PALM BEACH, FL, 33401, US | 321 13TH AVE N, ST PETERSBURG, FL, 337011123, US | |||||||||||||||||||||||||||||
|
Phone | +1 561-801-7600 |
Fax | 5616815610 |
Phone | +1 727-822-3030 |
Fax | 7278233522 |
Authorized person
Name | HOWARD JAFFE |
Role | PRESIDENT |
Phone | 2153466454 |
Taxonomy
Taxonomy Code | 314000000X - Skilled Nursing Facility |
License Number | SNF |
State | FL |
Is Primary | Yes |
Other Provider Identifiers
Issuer | MEDICAID |
Number | 025166600 |
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 |
---|---|---|---|---|---|---|
G08263700073 | CONCORDIA MANOR | ACTIVE | 2008-09-19 | 2028-12-31 | No data | 321 13TH AVENUE NORTH, SAINT PETERSBURG, FL, 33701 |
Event Type | Filed Date | Value | Description |
---|---|---|---|
CHANGE OF PRINCIPAL ADDRESS | 2024-03-11 | 1665 Palm Beach Lakes Blvd., Suite 400, West Palm Beach, FL 33401 | No data |
CHANGE OF MAILING ADDRESS | 2024-03-11 | 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 | 2024-03-11 |
ANNUAL REPORT | 2023-02-27 |
ANNUAL REPORT | 2022-03-30 |
AMENDED ANNUAL REPORT | 2021-06-15 |
ANNUAL REPORT | 2021-04-14 |
ANNUAL REPORT | 2020-04-24 |
ANNUAL REPORT | 2019-03-30 |
ANNUAL REPORT | 2018-04-09 |
ANNUAL REPORT | 2017-04-13 |
ANNUAL REPORT | 2016-04-29 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State