| Entity Name: | LIFESTYLES 1 HEALTHCARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 30 Aug 2001 (23 years ago) |
| Document Number: | L01000014843 |
| FEI/EIN Number | 260030243 |
| Mail Address: | 200 Clearwater Largo Road south, Largo, FL, 33770, US |
| Address: | 11300 110TH AVE NORTH, SEMINOLE, FL, 33778 |
| ZIP code: | 33778 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932173010 | 2006-02-15 | 2008-01-30 | 11300 110TH AVE, SEMINOLE, FL, 337783711, US | 11300 110TH AVE, SEMINOLE, FL, 337783711, US | |||||||||||||||||||||||||
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| Phone | +1 727-391-9986 |
| Fax | 7274565555 |
Authorized person
| Name | MR. WILLIAM C KELSEY |
| Role | MANAGER |
| Phone | 7273919986 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 1614096 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | L4B |
| State | FL |
| Name | Role | Address |
|---|---|---|
| RK1 | Agent | 200 Clearwater Largo Road south, Largo, FL, 33770 |
| Name | Role | Address |
|---|---|---|
| RUSSELL TERRY P | Manager | 11300 110TH AVE NORTH, SEMINOLE, FL, 33778 |
| Name | Role | Address |
|---|---|---|
| Russell Nicky | Auth | 11300 110TH AVE NORTH, SEMINOLE, FL, 33778 |
| McQuilkin Michael | Auth | 11300 110TH AVE NORTH, SEMINOLE, FL, 33778 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000032997 | WRIGHTS HEALTHCARE AND REHABILIATION CENTER | ACTIVE | 2021-03-09 | 2026-12-31 | No data | 11300 110TH AVE N, SEMINOLE, FL, 33778 |
| G15000018820 | WRIGHT'S HEALTHCARE & REHABILITATION CENTER | EXPIRED | 2015-02-20 | 2020-12-31 | No data | 11300 110TH AVE N, SEMINOLE, FL, 33778 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-04-27 | RK1 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-27 | 200 Clearwater Largo Road south, Largo, FL 33770 | No data |
| CHANGE OF MAILING ADDRESS | 2020-06-30 | 11300 110TH AVE NORTH, SEMINOLE, FL 33778 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2002-04-26 | 11300 110TH AVE NORTH, SEMINOLE, FL 33778 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-27 |
| ANNUAL REPORT | 2023-05-01 |
| ANNUAL REPORT | 2022-04-30 |
| ANNUAL REPORT | 2021-03-09 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-05-01 |
| ANNUAL REPORT | 2017-07-13 |
| ANNUAL REPORT | 2016-04-30 |
| ANNUAL REPORT | 2015-01-06 |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DELIVERY ORDER | AWARD | 36C24825N0050 | 2024-10-01 | 2025-09-30 | 2025-09-30 | |||||||||||||||||||||||||
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| Obligated Amount | 800000.00 |
| Current Award Amount | 800000.00 |
| Potential Award Amount | 800000.00 |
Description
| Title | NURSING HOME SERVICES |
| NAICS Code | 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES) |
| Product and Service Codes | Q402: NURSING HOME, LONG-TERM & ADULT DAY CARE SERVICES |
Recipient Details
| Recipient | LIFESTYLES 1 HEALTHCARE LLC |
| UEI | ZJLNV8NA9FJ7 |
| Recipient Address | UNITED STATES, 11300 110TH AVE, LARGO, PINELLAS, FLORIDA, 337783711 |
| Unique Award Key | CONT_IDV_36C24824D0003_3600 |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Award Amounts
| Obligated Amount | 0.00 |
| Potential Award Amount | 4000000.00 |
Description
| Title | ESTIMATED NURSING HOME SERVICES |
| NAICS Code | 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES) |
| Product and Service Codes | Q402: NURSING HOME, LONG-TERM & ADULT DAY CARE SERVICES |
Recipient Details
| Recipient | LIFESTYLES 1 HEALTHCARE LLC |
| UEI | ZJLNV8NA9FJ7 |
| Recipient Address | UNITED STATES, 11300 110TH AVE, LARGO, PINELLAS, FLORIDA, 337783711 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
