| Entity Name: | TIERRA PINES CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
TIERRA PINES CENTER, 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: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 19 Dec 2002 (22 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 04 Oct 2021 (4 years ago) |
| Document Number: | L02000034243 |
| FEI/EIN Number |
431988462
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 885 Third Avenue, New York, NY, 10022, US |
| Mail Address: | 885 Third Avenue, New York, NY, 10022, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487642427 | 2005-10-13 | 2024-06-12 | 7380 ULMERTON RD, LARGO, FL, 337714512, US | 7380 ULMERTON RD, LARGO, FL, 337714512, US | |||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 727-535-9833 |
| Fax | 7275364525 |
Authorized person
| Name | MRS. JENNIFER ALISE ZIOLKOWSKI |
| Role | VP FINANCE |
| Phone | 8135586629 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF15580961 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | UNITED AMERICAN |
| Number | C105398 |
| State | FL |
| Issuer | MEDICAID |
| Number | 026056800 |
| State | FL |
| Issuer | UNITED HEALTH CARE |
| Number | 71-01209 |
| State | FL |
| Issuer | EVERCARE HH CONNECTION |
| Number | 71-05236 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | K85 |
| State | FL |
| Name | Role |
|---|---|
| PLATINUM AGENT SERVICES LLC | Agent |
| GABRIEL LIVING CENTERS, LLC | Managing Member |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000127515 | TIERRA PINES CENTER | ACTIVE | 2024-10-16 | 2029-12-31 | - | 885 THIRD AVENUE,29TH FLOOR, NEW YORK, NY, 10022 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-05-01 | 885 Third Avenue, 29th Floor, New York, NY 10022 | - |
| CHANGE OF MAILING ADDRESS | 2024-05-01 | 885 Third Avenue, 29th Floor, New York, NY 10022 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2024-05-01 | 155 OFFICE PLAZA DR, Suite D, TALLAHASSEE, FL 32301 | - |
| REGISTERED AGENT NAME CHANGED | 2023-06-29 | Platinum Agent Services LLC | - |
| REINSTATEMENT | 2021-10-04 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | - | - |
| LC AMENDMENT | 2021-01-29 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-01 |
| ANNUAL REPORT | 2023-06-29 |
| ANNUAL REPORT | 2022-05-01 |
| REINSTATEMENT | 2021-10-04 |
| LC Amendment | 2021-01-29 |
| ANNUAL REPORT | 2020-04-01 |
| ANNUAL REPORT | 2019-03-15 |
| ANNUAL REPORT | 2018-04-12 |
| ANNUAL REPORT | 2017-03-29 |
| ANNUAL REPORT | 2016-04-14 |
| Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 346209141 | 0420600 | 2022-09-09 | 7380 ULMERTON RD, LARGO, FL, 33771 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Type | Complaint |
| Activity Nr | 1933751 |
| Safety | Yes |
Violation Items
| Citation ID | 01001 |
| Citaton Type | Serious |
| Standard Cited | 19100303 G02 I A |
| Issuance Date | 2023-03-07 |
| Abatement Due Date | 2023-03-17 |
| Current Penalty | 5356.8 |
| Initial Penalty | 6696.0 |
| Final Order | 2023-05-04 |
| Nr Instances | 1 |
| Nr Exposed | 5 |
| Related Event Code (REC) | Complaint |
| Gravity | 1 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.303(g)(2)(i)(A):Except as elsewhere required or permitted by Subpart S of Part 1910, live parts of electric equipment operating at 50 volts or more were not guarded against accidental contact by use of approved cabinets or by location in a room, vault, or similar enclosure that is accessible only to qualified persons: a) Laundry Room - On or about September 09, 2022, the employer exposed employees to electrical shock hazards, in that the industrial washing machine safety switch was unsecured to prevent unauthorized access to energized three phase, 30 amp, 240 volt wiring. |
| Citation ID | 01002 |
| Citaton Type | Serious |
| Standard Cited | 19100305 G02 III |
| Issuance Date | 2023-03-07 |
| Abatement Due Date | 2023-03-17 |
| Current Penalty | 5356.8 |
| Initial Penalty | 6696.0 |
| Final Order | 2023-05-04 |
| Nr Instances | 1 |
| Nr Exposed | 10 |
| Gravity | 1 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.305(g)(2)(iii):Flexible cords were not connected to devices and fittings so that tension would not be transmitted to joints or terminal screws: a) Laundry Room - On or about September 09, 2022, the employer exposed employees to electrical shock hazards, in that flexible electrical conduit used to provide power to the industrial mashing machine was missing strain relief to the three phase, 30 amp, 240 volt safety switch. |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
