| Entity Name: | PEACOCK INVESTMENT ENTERPRISES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 28 Dec 2005 (19 years ago) |
| Date of dissolution: | 27 Sep 2013 (11 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2013 (11 years ago) |
| Document Number: | L05000122842 |
| FEI/EIN Number | 203989825 |
| Address: | 458 N.W. MARION, MADISON, FL, 32340 |
| Mail Address: | 458 N.W. MARION, MADISON, FL, 32340 |
| ZIP code: | 32340 |
| County: | Madison |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770886475 | 2010-12-19 | 2010-12-19 | 458 NW MARION ST, MADISON, FL, 323401431, US | 458 NW MARION ST, MADISON, FL, 323401431, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 850-973-9800 |
| Fax | 8509739600 |
Authorized person
| Name | RACHEL PEACOCK |
| Role | ADMINISTRATOR |
| Phone | 8509739800 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL10759 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL10295 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3104A0625X - Assisted Living Facility (Mental Illness) |
| License Number | AL10795 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 142510200 |
| State | FL |
| Issuer | MEDICAID |
| Number | 689952800 |
| State | FL |
| Issuer | MEDICAID |
| Number | 689952801 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PEACOCK RACHEL | Agent | 458 NW MARION STREET, MADISON, FL, 32340 |
| Name | Role | Address |
|---|---|---|
| PEACOCK RACHEL | Managing Member | 458 NW MARION STREET, MADISON, FL, 32340 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-04-30 | 458 NW MARION STREET, MADISON, FL 32340 | No data |
| LC AMENDMENT | 2010-06-07 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-04-30 | 458 N.W. MARION, MADISON, FL 32340 | No data |
| CHANGE OF MAILING ADDRESS | 2009-04-30 | 458 N.W. MARION, MADISON, FL 32340 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J12000190515 | LAPSED | 1000000256749 | MADISON | 2012-03-07 | 2022-03-14 | $ 474.45 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, LAKE CITY SERVICE CENTER, 1401 W US HIGHWAY 90 STE 100, LAKE CITY FL320556123 |
| J11000094685 | LAPSED | 1000000202964 | MADISON | 2011-02-07 | 2021-02-16 | $ 4,138.17 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, LAKE CITY SERVICE CENTER, 1401 W US HIGHWAY 90 STE 100, LAKE CITY FL320556123 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2012-04-29 |
| ANNUAL REPORT | 2011-04-30 |
| LC Amendment | 2010-06-07 |
| ANNUAL REPORT | 2010-03-22 |
| ANNUAL REPORT | 2009-04-30 |
| ANNUAL REPORT | 2008-04-11 |
| ANNUAL REPORT | 2007-03-07 |
| Florida Limited Liability | 2005-12-28 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
