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  5. SUPREME HOME HEALTH CARE, LLC

SUPREME HOME HEALTH CARE, LLC

Company Details

Entity Name: SUPREME HOME HEALTH CARE, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 24 Apr 2006 (19 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 01 Nov 2012 (12 years ago)
Document Number: L06000042499
FEI/EIN Number 204751263
Address: 8910 MIRAMAR PARKWAY, STE #210, MIRAMAR, FL, 33025, US
Mail Address: 8910 MIRAMAR PARKWAY, STE #210, MIRAMAR, FL, 33025, US
ZIP code: 33025
County: Broward
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1912095142 2006-10-11 2010-10-29 8910 MIRAMAR PKWY STE 315, MIRAMAR, FL, 330254100, US 8910 MIRAMAR PKWY STE 315, MIRAMAR, FL, 330254100, US

Contacts
Phone +1 954-431-1681
Fax 9544311699

Authorized person
Name MR. CANUTE V ANDERSON
Role ADMINISTRATOR
Phone 9544311681

Taxonomy
Taxonomy Code 251E00000X - Home Health Agency
License Number 299992504
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SUPREME HOME HEALTH CARE LLC 401K PLAN 2023 204751263 2024-04-26 SUPREME HOME HEALTH CARE LLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621610
Sponsor’s telephone number 9546146353
Plan sponsor’s address 8910 MIRAMAR PKWY, SUITE 210, MIRAMAR, FL, 33025

Signature of
Role Plan administrator
Date 2024-04-26
Name of individual signing CANUTE ANDERSON
Valid signature Filed with authorized/valid electronic signature
SUPREME HOME HEALTH CARE LLC 401K PLAN 2022 204751263 2023-04-24 SUPREME HOME HEALTH CARE LLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621610
Sponsor’s telephone number 9546146353
Plan sponsor’s address 8910 MIRAMAR PKWY, SUITE 210, MIRAMAR, FL, 33025

Signature of
Role Plan administrator
Date 2023-04-24
Name of individual signing CANUTE ANDERSON
Valid signature Filed with authorized/valid electronic signature
SUPREME HOME HEALTH CARE LLC 401K PLAN 2021 204751263 2022-10-05 SUPREME HOME HEALTH CARE LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Sponsor’s telephone number 9546146353
Plan sponsor’s address 8910 MIRAMAR PKWY, SUITE 210, MIRAMAR, FL, 33025

Signature of
Role Plan administrator
Date 2022-10-05
Name of individual signing CANUTE ANDERSON
Valid signature Filed with authorized/valid electronic signature
SUPREME HOME HEALTH CARE LLC 401(K) PLAN 2021 204751263 2022-05-28 SUPREME HOME HEALTH CARE LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621610
Sponsor’s telephone number 9544311681
Plan sponsor’s address 8910 MIRAMAR PKWY, SUITE210, MIRAMAR, FL, 33025

Signature of
Role Plan administrator
Date 2022-05-28
Name of individual signing CANUTE ANDERSON
Valid signature Filed with authorized/valid electronic signature
SUPREME HOME HEALTH CARE LLC 401(K) PLAN 2020 204751263 2021-06-17 SUPREME HOME HEALTH CARE LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621610
Sponsor’s telephone number 9546146353
Plan sponsor’s address 8910 MIRAMAR PWY STE 210, MIRAMAR, FL, 33025

Signature of
Role Plan administrator
Date 2021-06-17
Name of individual signing CANUTE ANDERSON
Valid signature Filed with authorized/valid electronic signature
SUPREME HOME HEALTH CARE LLC 401(K) PLAN 2019 204751263 2020-08-20 SUPREME HOME HEALTH CARE LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621610
Sponsor’s telephone number 9546146353
Plan sponsor’s address 8910 MIRAMAR PWY STE 305, MIRAMAR, FL, 33025

Signature of
Role Plan administrator
Date 2020-08-20
Name of individual signing CANUTE ANDERSON
Valid signature Filed with authorized/valid electronic signature
SUPREME HOME HEALTH CARE LLC 401(K) PLAN 2018 204751263 2019-06-20 SUPREME HOME HEALTH CARE LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621610
Sponsor’s telephone number 9546146353
Plan sponsor’s address 8910 MIRAMAR PWY STE 305, MIRAMAR, FL, 33025

Signature of
Role Plan administrator
Date 2019-06-20
Name of individual signing ANDERSON CANUTE
Valid signature Filed with authorized/valid electronic signature
SUPREME HOME HEALTH CARE LLC 401(K) PLAN 2017 204751263 2019-08-23 SUPREME HOME HEALTH CARE LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621610
Sponsor’s telephone number 9546146353
Plan sponsor’s address 8910 MIRAMAR PWY STE 305, MIRAMAR, FL, 33025

Signature of
Role Plan administrator
Date 2019-08-23
Name of individual signing ANDERSON CANUTE
Valid signature Filed with authorized/valid electronic signature
SUPREME HOME HEALTH CARE LLC 401(K) PLAN 2017 204751263 2019-06-20 SUPREME HOME HEALTH CARE LLC 7
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621610
Sponsor’s telephone number 9546146353
Plan sponsor’s address 8910 MIRAMAR PWY STE 305, MIRAMAR, FL, 33025

Signature of
Role Plan administrator
Date 2019-06-20
Name of individual signing ANDERSON CANUTE
Valid signature Filed with authorized/valid electronic signature
SUPREME HOME HEALTH CARE LLC 401(K) PLAN 2016 204751263 2017-06-01 SUPREME HOME HEALTH CARE LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621610
Sponsor’s telephone number 9546146353
Plan sponsor’s address 8910 MIRAMAR PWY STE 305, MIRAMAR, FL, 33025

Signature of
Role Plan administrator
Date 2017-06-01
Name of individual signing ANDERSON CANUTE
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ANDERSON CANUTE Agent 8910 MIRAMAR PARKWAY, MIRAMAR, FL, 33025

Managing Member

Name Role Address
ANDERSON CANUTE Managing Member 13122 SW 30TH STREET, MIRAMAR, FL, 33027
ANDERSON PETA-ANN Managing Member 13122 SW 30TH STREET, MIRAMAR, FL, 33027

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2019-04-24 8910 MIRAMAR PARKWAY, STE 210, MIRAMAR, FL 33025 No data
CHANGE OF PRINCIPAL ADDRESS 2019-04-08 8910 MIRAMAR PARKWAY, STE #210, MIRAMAR, FL 33025 No data
CHANGE OF MAILING ADDRESS 2019-04-08 8910 MIRAMAR PARKWAY, STE #210, MIRAMAR, FL 33025 No data
REINSTATEMENT 2012-11-01 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2012-09-28 No data No data
REINSTATEMENT 2011-10-18 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2011-09-23 No data No data

Debts

Document Number Status Case Number Name of Court Date of Entry Expiration Date Amount Due Plaintiff
J10000293685 TERMINATED 1000000151234 BROWARD 2010-01-13 2030-02-16 $ 483.67 STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE/CENTRAL COLLECTIONS UNIT, 5050 W TENNESSEE ST, TALLAHASSEE FL323996586

Documents

Name Date
ANNUAL REPORT 2024-01-15
ANNUAL REPORT 2023-01-31
ANNUAL REPORT 2022-02-21
ANNUAL REPORT 2021-04-07
ANNUAL REPORT 2020-02-19
ANNUAL REPORT 2019-04-24
ANNUAL REPORT 2018-01-15
ANNUAL REPORT 2017-08-10
ANNUAL REPORT 2016-01-22
ANNUAL REPORT 2015-03-30

Related by officers

ANDERSON CANUTE

HEART TO HEART WORLD MISSION INC.

Related by address

No related companies by address

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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