| Entity Name: | FI-HIGHLAND PINES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 23 Dec 2002 (22 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 22 Feb 2016 (9 years ago) |
| Document Number: | L02000034773 |
| FEI/EIN Number | 32-0051433 |
| Address: | 1665 Palm Beach Lakes Blvd., Suite 400, West Palm Beach, FL, 33401, US |
| Mail Address: | 1665 Palm Beach Lakes Blvd., Suite 400, West Palm Beach, FL, 33401, US |
| ZIP code: | 33401 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1316352172 | 2014-06-30 | 2014-06-30 | 1520 JEFFORDS ST, CLEARWATER, FL, 337564449, US | 1520 JEFFORDS ST, CLEARWATER, FL, 337564449, US | |||||||||||||||||||||||||
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| Phone | +1 727-446-0581 |
| Fax | 7274429425 |
Authorized person
| Name | HOWARD JAFFE |
| Role | DIRECTOR |
| Phone | 2153466454 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | 7118 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 686913100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| Jaffe Howard | Manager | 1665 Palm Beach Lakes Blvd., West Palm Beach, FL, 33401 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000050425 | HIGHLAND PINES REHABILITATION CENTER | ACTIVE | 2016-05-19 | 2026-12-31 | No data | 1665 PALM BEACH LAKES BLVD., SUITE 400, WEST PALM BEACH, FL, 33401 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-01 | 1665 Palm Beach Lakes Blvd., Suite 400, West Palm Beach, FL 33401 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-01 | 1665 Palm Beach Lakes Blvd., Suite 400, West Palm Beach, FL 33401 | No data |
| LC STMNT OF RA/RO CHG | 2016-02-22 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-02-22 | CT CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-02-22 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-01 |
| ANNUAL REPORT | 2023-02-27 |
| ANNUAL REPORT | 2022-03-25 |
| AMENDED ANNUAL REPORT | 2021-06-15 |
| ANNUAL REPORT | 2021-04-13 |
| ANNUAL REPORT | 2020-04-22 |
| ANNUAL REPORT | 2019-03-29 |
| ANNUAL REPORT | 2018-04-09 |
| ANNUAL REPORT | 2017-04-12 |
| ANNUAL REPORT | 2016-04-29 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
