| Entity Name: | WASHINGTON MANOR HEALTH CARE ASSOCIATES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| 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: | L01000012579 |
| FEI/EIN Number | 582639489 |
| Mail Address: | 303 PERIMETER CENTER NORTH, SUITE 500, ATLANTA, GA, 30346, US |
| Address: | 4200 WASHINGTON STREET, HOLLYWOOD, FL, 33021, US |
| ZIP code: | 33021 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750337671 | 2006-05-25 | 2012-08-02 | 4200 WASHINGTON ST, HOLLYWOOD, FL, 330217353, US | 4200 WASHINGTON ST, HOLLYWOOD, FL, 330217353, US | |||||||||||||||||||||||||
|
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| Phone | +1 954-981-6300 |
| Fax | 9549672725 |
Authorized person
| Name | CARMEN J. TELOT |
| Role | MANAGER |
| Phone | 9549816300 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF15840951 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 025253100 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| TELOT CARMEN J | Manager | 4200 WASHINGTON STREET, HOLLYWOOD, FL, 33021 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| MERGER | 2012-02-01 | No data | CORPORATION WAS PART OF A MERGER. QUALIFIED CORPORATION WAS L11000131286. MERGER NUMBER 300000119943 |
| CHANGE OF MAILING ADDRESS | 2011-04-27 | 4200 WASHINGTON STREET, HOLLYWOOD, FL 33021 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-04-29 | 4200 WASHINGTON STREET, HOLLYWOOD, FL 33021 | No data |
| REGISTERED AGENT NAME CHANGED | 2005-04-12 | CORPORATION SERVICE COMPANY | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-04-12 | 1201 HAYS STREET, TALLAHASSEE, FL 32301-2525 | No data |
| AMENDED AND RESTATEDARTICLES | 2004-08-09 | No data | No data |
| AMENDED AND RESTATEDARTICLES | 2004-04-07 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-04-27 |
| ANNUAL REPORT | 2010-04-29 |
| 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 |
| ANNUAL REPORT | 2004-04-20 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
