| Entity Name: | COUNTRYSIDE HEALTH CARE ASSOCIATES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
COUNTRYSIDE HEALTH CARE ASSOCIATES, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 30 Jul 2001 (24 years ago) |
| Date of dissolution: | 01 Feb 2012 (13 years ago) |
| Last Event: | CORPORATE MERGER |
| Event Date Filed: | 01 Feb 2012 (13 years ago) |
| Document Number: | L01000012552 |
| FEI/EIN Number |
582639428
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Mail Address: | 303 PERIMETER CENTER NORTH, SUITE 500, ATLANTA, GA, 30346, US |
| Address: | 3825 COUNTRYSIDE BOULEVARD N, PALM HARBOR, FL, 34684, US |
| ZIP code: | 34684 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1396791349 | 2006-05-25 | 2012-08-02 | 3825 COUNTRYSIDE BLVD N, PALM HARBOR, FL, 346844928, US | 3825 COUNTRYSIDE BLVD N, PALM HARBOR, FL, 346844928, US | |||||||||||||||||||||||||
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| Phone | +1 727-784-2848 |
| Fax | 7277811402 |
Authorized person
| Name | SANDRA A. RYCZEK |
| Role | MANAGER |
| Phone | 7277842848 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF11060962 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 025211500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| VERMILYEA KIMBERLY A | Manager | 3825 COUNTRYSIDE BOULEVARD N, PALM HARBOR, FL, 34684 |
| CORPORATION SERVICE COMPANY | Agent | - |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| MERGER | 2012-02-01 | - | CORPORATION WAS PART OF A MERGER. QUALIFIED CORPORATION WAS L11000131233. MERGER NUMBER 900000119909 |
| CHANGE OF PRINCIPAL ADDRESS | 2011-04-21 | 3825 COUNTRYSIDE BOULEVARD N, PALM HARBOR, FL 34684 | - |
| CHANGE OF MAILING ADDRESS | 2011-04-21 | 3825 COUNTRYSIDE BOULEVARD N, PALM HARBOR, FL 34684 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2005-04-11 | 1201 HAYS STREET, TALLAHASSEE, FL 32301-2525 | - |
| REGISTERED AGENT NAME CHANGED | 2005-04-11 | CORPORATION SERVICE COMPANY | - |
| AMENDED AND RESTATEDARTICLES | 2004-08-09 | - | - |
| AMENDED AND RESTATEDARTICLES | 2004-04-01 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-04-21 |
| ANNUAL REPORT | 2010-04-27 |
| ANNUAL REPORT | 2009-04-30 |
| ANNUAL REPORT | 2008-04-30 |
| ANNUAL REPORT | 2007-04-02 |
| ANNUAL REPORT | 2006-04-13 |
| ANNUAL REPORT | 2005-04-29 |
| Reg. Agent Change | 2005-04-11 |
| Amended and Restated Articles | 2004-08-09 |
| ANNUAL REPORT | 2004-04-20 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
