| Entity Name: | COMMUNITY EXPERIENCES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 28 Mar 2005 (20 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 03 Jul 2012 (13 years ago) |
| Document Number: | L05000030396 |
| FEI/EIN Number | 51-0540056 |
| Mail Address: | 11107 LITTLE CREEK LANE, PENSACOLA, FL 32506 |
| Address: | 321 N Devillers St, PENSACOLA, FL 32502 |
| ZIP code: | 32502 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639579568 | 2014-08-28 | 2014-08-28 | 11107 LITTLE CREEK LN, PENSACOLA, FL, 325068262, US | 321 N DEVILLERS ST SUITE 221, PENSACOLA, FL, 32502, US | |||||||||||||||||||||||||||||
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| Phone | +1 850-261-8403 |
| Fax | 8504588177 |
Authorized person
| Name | TRACY L CARREOLA |
| Role | DIRECTOR/OWNER |
| Phone | 8502618403 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 002217700 |
| State | FL |
| Issuer | MEDICAID |
| Number | 686104196 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CARREOLA, TRACY L | Agent | 11107 LITTLE CREEK LANE, PENSACOLA, FL 32506 |
| Name | Role | Address |
|---|---|---|
| CARREOLA, TRACY L | Manager | 11107 LITTLE CREEK LANE, PENSACOLA, FL 32506 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-01-30 | 321 N Devillers St, PENSACOLA, FL 32502 | No data |
| REINSTATEMENT | 2012-07-03 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| CANCEL ADM DISS/REV | 2007-10-09 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| AMENDMENT | 2005-10-06 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-30 |
| ANNUAL REPORT | 2023-02-22 |
| ANNUAL REPORT | 2022-03-16 |
| ANNUAL REPORT | 2021-03-23 |
| ANNUAL REPORT | 2020-02-15 |
| ANNUAL REPORT | 2019-03-21 |
| ANNUAL REPORT | 2018-04-24 |
| ANNUAL REPORT | 2017-03-31 |
| ANNUAL REPORT | 2016-03-28 |
| ANNUAL REPORT | 2015-02-20 |
Date of last update: 04 Jan 2025
Sources: Florida Department of State
