| Entity Name: | AT HOME OF BREVARD, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
AT HOME OF BREVARD, 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: | 19 Apr 2002 (23 years ago) |
| Date of dissolution: | 22 Sep 2017 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (8 years ago) |
| Document Number: | L02000009417 |
| FEI/EIN Number |
020584005
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 3116 Wendel Rd SE, PALM BAY, FL, 32909, US |
| Mail Address: | 3116 Wendel Rd SE, PALM BAY, FL, 32909, US |
| ZIP code: | 32909 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730314311 | 2009-05-26 | 2009-05-26 | 1351 DARROW RD SW, PALM BAY, FL, 329086248, US | 1351 DARROW RD SW, PALM BAY, FL, 329086248, US | |||||||||||||||||||||||||
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| Phone | +1 321-676-6331 |
| Fax | 3219512118 |
Authorized person
| Name | MICHAEL JOSEPH CULLEN |
| Role | ADMIINISTRATOR |
| Phone | 3216766331 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | 9150 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 684950400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CULLEN CHRISTINE M | Manager | 3116 Wendel Rd SE, PALM BAY, FL, 32909 |
| THIBAULT AIMEE L | Manager | 3132 WENDEL RD SE, PALM BAY, FL, 32909 |
| CULLEN Christine M | Agent | 3116 Wendel Rd SE, PALM BAY, FL, 32909 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000052291 | GOLDEN WINGS DARROW | EXPIRED | 2014-05-30 | 2019-12-31 | - | 1351 DARROW RD SW, PALM BAY, FL, 32908 |
| G14000004312 | GOLDEN WINGS WENDEL | EXPIRED | 2014-01-13 | 2019-12-31 | - | 3116 WENDEL RD SE, PALM BAY, FL, 32909 |
| G08042900421 | GOLDEN WINGS | EXPIRED | 2008-02-10 | 2013-12-31 | - | 1351 DARROW RD SW, PALM BAY, FL, 32908 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2016-03-30 | 3116 Wendel Rd SE, PALM BAY, FL 32909 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2016-03-30 | 3116 Wendel Rd SE, PALM BAY, FL 32909 | - |
| CHANGE OF MAILING ADDRESS | 2015-05-19 | 3116 Wendel Rd SE, PALM BAY, FL 32909 | - |
| REGISTERED AGENT NAME CHANGED | 2013-04-30 | CULLEN, Christine M | - |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J18000583799 | LAPSED | 14-472-D4 | LEON | 2018-05-22 | 2023-08-28 | $8,386.02 | DFS DIVISION OF WORKERS COMPENSATION, 200 EAST GAINES STREET, TALLAHASSEE, FL 32399-4228 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-03-30 |
| ANNUAL REPORT | 2015-05-19 |
| ANNUAL REPORT | 2014-04-30 |
| ANNUAL REPORT | 2013-04-30 |
| ANNUAL REPORT | 2012-03-25 |
| ANNUAL REPORT | 2011-03-31 |
| ANNUAL REPORT | 2010-02-16 |
| ANNUAL REPORT | 2009-06-15 |
| ANNUAL REPORT | 2008-12-12 |
| ANNUAL REPORT | 2008-01-23 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
