| Entity Name: | SCG GRACEWOOD, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
SCG GRACEWOOD, 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: | 03 Jun 2005 (20 years ago) |
| Date of dissolution: | 22 Mar 2022 (3 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 22 Mar 2022 (3 years ago) |
| Document Number: | L05000055153 |
| FEI/EIN Number |
202971168
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1240 MARBELLA PLAZA DRIVE, TAMPA, FL, 33619 |
| Mail Address: | 1240 MARBELLA PLAZA DRIVE, TAMPA, FL, 33619 |
| ZIP code: | 33619 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255333290 | 2005-08-10 | 2015-01-12 | 1240 MARBELLA PLAZA DR, TAMPA, FL, 336197906, US | 8600 US HIGHWAY 19 N, PINELLAS PARK, FL, 33782, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 813-341-2700 |
| Fax | 8133412755 |
| Phone | +1 727-541-7515 |
| Fax | 7275459473 |
Authorized person
| Name | MR. KEVIN GOYER |
| Role | PRESIDENT |
| Phone | 8133412700 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | NH4155 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 031664400 |
| State | FL |
| Issuer | BLUE CROSS AND BLUE SHIELD |
| Number | L85 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Vaughan Michelle | Agent | 1240 MARBELLA PLAZA DRIVE, TAMPA, FL, 33619 |
| SENIOR CARE GROUP, INC. | Manager | 1240 MARBELLA PLAZA DRIVE, TAMPA, FL, 33619 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2022-03-22 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | - | - |
| REGISTERED AGENT NAME CHANGED | 2018-04-30 | Vaughan, Michelle | - |
| REINSTATEMENT | 2016-11-11 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | - | - |
| REINSTATEMENT | 2015-10-01 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | - | - |
| CHANGE OF MAILING ADDRESS | 2007-03-29 | 1240 MARBELLA PLAZA DRIVE, TAMPA, FL 33619 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2007-03-29 | 1240 MARBELLA PLAZA DRIVE, TAMPA, FL 33619 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2007-03-29 | 1240 MARBELLA PLAZA DRIVE, TAMPA, FL 33619 | - |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2022-03-22 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-05-01 |
| REINSTATEMENT | 2016-11-11 |
| REINSTATEMENT | 2015-10-01 |
| ANNUAL REPORT | 2014-04-08 |
| ANNUAL REPORT | 2013-04-10 |
| ANNUAL REPORT | 2012-02-02 |
| ANNUAL REPORT | 2011-01-04 |
| ANNUAL REPORT | 2010-01-06 |
Date of last update: 01 May 2025
Sources: Florida Department of State
