| Entity Name: | NORTH OKALOOSA HEALTH CARE ASSOCIATES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
NORTH OKALOOSA 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: | L01000012576 |
| FEI/EIN Number |
582639467
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Mail Address: | 303 PERIMETER CENTER NORTH, SUITE 500, ATLANTA, GA, 30346, US |
| Address: | 500 HOSPITAL DRIVE, CRESTVIEW, FL, 32539, US |
| ZIP code: | 32539 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225084833 | 2006-05-25 | 2012-11-04 | 500 HOSPITAL DR, CRESTVIEW, FL, 325397355, US | 500 HOSPITAL DR, CRESTVIEW, FL, 325397355, US | |||||||||||||||||||||||||
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| Phone | +1 850-689-3146 |
| Fax | 8506892286 |
Authorized person
| Name | MATTHEW H. BALTZ |
| Role | MANAGER |
| Phone | 8506893146 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF130471012 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 025237900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ALCORN DANA L | Manager | 500 HOSPITAL DRIVE, CRESTVIEW, FL, 32539 |
| CORPORATION SERVICE COMPANY | Agent | - |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| MERGER | 2012-02-01 | - | CORPORATION WAS PART OF A MERGER. QUALIFIED CORPORATION WAS L11000131345. MERGER NUMBER 900000119999 |
| CHANGE OF PRINCIPAL ADDRESS | 2011-04-26 | 500 HOSPITAL DRIVE, CRESTVIEW, FL 32539 | - |
| CHANGE OF MAILING ADDRESS | 2011-04-26 | 500 HOSPITAL DRIVE, CRESTVIEW, FL 32539 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2005-04-12 | 1201 HAYS STREET, TALLAHASSEE, FL 32301-2525 | - |
| REGISTERED AGENT NAME CHANGED | 2005-04-12 | CORPORATION SERVICE COMPANY | - |
| AMENDED AND RESTATEDARTICLES | 2004-08-09 | - | - |
| AMENDED AND RESTATEDARTICLES | 2004-04-05 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-04-26 |
| ADDRESS CHANGE | 2010-11-05 |
| ANNUAL REPORT | 2010-04-28 |
| ANNUAL REPORT | 2009-05-01 |
| ANNUAL REPORT | 2008-04-30 |
| ANNUAL REPORT | 2007-04-02 |
| ANNUAL REPORT | 2006-04-14 |
| ANNUAL REPORT | 2005-04-29 |
| Reg. Agent Change | 2005-04-12 |
| Amended and Restated Articles | 2004-08-09 |
| Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 311820765 | 0419700 | 2009-03-25 | 500 S. HOSPITAL DRIVE, CRESTVIEW, FL, 32539 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Citation ID | 01001A |
| Citaton Type | Serious |
| Standard Cited | 19101030 F02 I |
| Issuance Date | 2009-04-14 |
| Abatement Due Date | 2009-05-08 |
| Current Penalty | 641.0 |
| Initial Penalty | 1375.0 |
| Nr Instances | 4 |
| Nr Exposed | 4 |
| Gravity | 03 |
| Citation ID | 01001B |
| Citaton Type | Serious |
| Standard Cited | 19101030 F02 IV |
| Issuance Date | 2009-04-14 |
| Abatement Due Date | 2009-05-08 |
| Nr Instances | 2 |
| Nr Exposed | 2 |
| Gravity | 01 |
| Citation ID | 01002 |
| Citaton Type | Serious |
| Standard Cited | 19101030 H05 I |
| Issuance Date | 2009-04-14 |
| Abatement Due Date | 2009-05-08 |
| Current Penalty | 641.0 |
| Initial Penalty | 1050.0 |
| Nr Instances | 2 |
| Nr Exposed | 5 |
| Gravity | 01 |
| Citation ID | 02001A |
| Citaton Type | Other |
| Standard Cited | 19040029 B01 |
| Issuance Date | 2009-04-14 |
| Abatement Due Date | 2009-05-08 |
| Current Penalty | 643.0 |
| Initial Penalty | 1400.0 |
| Nr Instances | 3 |
| Nr Exposed | 1 |
| Gravity | 00 |
| Citation ID | 02001B |
| Citaton Type | Other |
| Standard Cited | 19040029 B06 |
| Issuance Date | 2009-04-14 |
| Abatement Due Date | 2009-05-08 |
| Nr Instances | 2 |
| Nr Exposed | 2 |
| Gravity | 00 |
| Citation ID | 02002 |
| Citaton Type | Other |
| Standard Cited | 19101200 E01 I |
| Issuance Date | 2009-04-14 |
| Abatement Due Date | 2009-05-08 |
| Nr Instances | 1 |
| Nr Exposed | 136 |
| Gravity | 01 |
Date of last update: 02 May 2025
Sources: Florida Department of State
