| Entity Name: | ACV HEALTH SERVICES, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 25 Apr 2003 (22 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 05 Apr 2017 (8 years ago) |
| Document Number: | L03000014876 |
| FEI/EIN Number | 651186341 |
| Address: | 10676 MARVIN JONES BLVD, LIVE OAK, FL, 32060, US |
| Mail Address: | P.O. BOX 4332, DOWLING PARK, FL, 32064, US |
| ZIP code: | 32060 |
| County: | Suwannee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336253020 | 2006-08-18 | 2008-08-28 | PO BOX 4674, DOWLING PARK, FL, 320641507, US | 10676 MARVIN JONES BLVD, LIVE OAK, FL, 320648242, US | |||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||
| Phone | +1 386-658-5450 |
| Fax | 3866585111 |
| Phone | +1 386-658-5550 |
| Fax | 3866585666 |
Authorized person
| Name | MR. CRAG A CARTER |
| Role | PRESIDENT/CEO |
| Phone | 3866585500 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 1178096 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 026876300 |
| State | FL |
| Issuer | BCBS UB92 |
| Number | L3Z |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Kennon Todd | Agent | 582 W Duval St, Lake City, FL, 32056 |
| Name | Role | Address |
|---|---|---|
| CARTER CRAIG | Manager | 10680 DOWLING PARK DR, LIVE OAK, FL, 32060 |
| Name | Role | Address |
|---|---|---|
| Hilliard Keri | Vice Chairman | 10233 229th Lane, Live Oak, FL, 32060 |
| Name | Role | Address |
|---|---|---|
| Willis Michael | Treasurer | 10680 Dowling Park Drive, Live Oak, FL, 32060 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G03210700023 | GOOD SAMARITAN CENTER | ACTIVE | 2003-07-29 | 2028-12-31 | No data | 10676 MARVIN JONES BOULEVARD, LIVE OAK, FL, 32060 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2019-04-04 | Kennon, Todd | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-04-04 | 582 W Duval St, Lake City, FL 32056 | No data |
| LC AMENDMENT | 2017-04-05 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-04-16 | 10676 MARVIN JONES BLVD, LIVE OAK, FL 32060 | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-09-03 |
| ANNUAL REPORT | 2024-02-13 |
| ANNUAL REPORT | 2023-01-27 |
| ANNUAL REPORT | 2022-03-09 |
| ANNUAL REPORT | 2021-02-18 |
| ANNUAL REPORT | 2020-03-17 |
| ANNUAL REPORT | 2019-04-04 |
| ANNUAL REPORT | 2018-04-16 |
| ANNUAL REPORT | 2017-04-27 |
| LC Amendment | 2017-04-05 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
