| Entity Name: | SENIOR HOUSING MANAGEMENT PROVIDER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 16 Jul 2008 (17 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 13 Dec 2018 (6 years ago) |
| Document Number: | L08000068842 |
| FEI/EIN Number | 26-3012247 |
| Mail Address: | 4901 NW 17th Way, Suite 303, Ft Lauderdale, FL 33309 |
| Address: | 534 Datura St, West Palm Beach, FL 33401 |
| ZIP code: | 33401 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730311556 | 2009-08-12 | 2009-08-12 | 534 DATURA ST, WEST PALM BEACH, FL, 334015308, US | 534 DATURA ST, WEST PALM BEACH, FL, 334015308, US | |||||||||||||||||||
|
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| Phone | +1 561-659-9330 |
| Fax | 5616590732 |
Authorized person
| Name | RICKI KANETI |
| Role | EXECUTIVE DIRECTOR |
| Phone | 5616599330 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL7617 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ITSKOVICH, DAVID | Agent | 4901 NW 17th Way STE 303, Suite 303, Fort Lauderdale, FL 33309 |
| Name | Role | Address |
|---|---|---|
| KANETI, RICKI | Manager | 1645 Palm Beach Lakes Blvd, Suite 1200 West Palm Beach, FL 33401 |
| EISENMANN, MARC | Manager | 3350 SW 57TH PL, FORT LAUDERDALE, FL 33312 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000055022 | COLONIAL ASSISTED LIVING AT WPB | ACTIVE | 2024-04-25 | 2029-12-31 | No data | 4901 NW 17TH WAY, FORT LAUDERDALE, FL, 33309 |
| G23000086866 | COLONIAL ASSISTED LIVING AT WEST PALM BEACH, FL | ACTIVE | 2023-07-24 | 2028-12-31 | No data | 4901 NW 17TH WAY, STE 303, FORT LAUDERDALE, FL, 33309 |
| G23000050618 | COLONIAL ASSISTED LIVING AT WEST PALM BEACH | ACTIVE | 2023-04-21 | 2028-12-31 | No data | 4901 NW 17TH WAY, SUITE 303, FT LAUDERDALE, FL, 33309 |
| G19000024017 | COLONIAL ASSISTED LIVING AT WEST PALM BEACH, FI | EXPIRED | 2019-02-19 | 2024-12-31 | No data | 100 NE 3RD AVE, STE 620, FT LAUDERDALE, FL, 33301 |
| G17000052341 | CITY WALK ACTIVE LIVING | EXPIRED | 2017-05-11 | 2022-12-31 | No data | 200 S ROSEMARY AVE, UNIT 2, WEST PALMBEACH, FL, 33401 |
| G11000031931 | CITY WALK ASSISTED LIVING | EXPIRED | 2011-03-30 | 2016-12-31 | No data | SENIOR HOUSING MANAGEMENT PROVIDER, 534 DATURA ST, WEST PALM BEACH, FL, 33401 |
| G10000039582 | CITY WALK ACTIVE LIVING | EXPIRED | 2010-05-04 | 2015-12-31 | No data | CITY WALK ACTIVE LIVING, 534 DATURA ST, WPB, FL, 33401 |
| G09000129173 | CITY PLACE ACTIVE LIVING | EXPIRED | 2009-06-29 | 2014-12-31 | No data | 534 DATURA STREET, WEST PALM BEACH, FL, 33401 |
| G09000114099 | PALM BEACH ASSISTED LIVING FACILITY | EXPIRED | 2009-06-05 | 2014-12-31 | No data | 534 DATURA STREET, WEST PALM BEACH, FL, 33401 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-25 | 4901 NW 17th Way STE 303, Suite 303, Fort Lauderdale, FL 33309 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-21 | 534 Datura St, West Palm Beach, FL 33401 | No data |
| REGISTERED AGENT NAME CHANGED | 2019-02-07 | ITSKOVICH, DAVID | No data |
| LC STMNT OF RA/RO CHG | 2018-12-13 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-04-02 | 534 Datura St, West Palm Beach, FL 33401 | No data |
| LC STMNT OF RA/RO CHG | 2017-10-05 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-25 |
| ANNUAL REPORT | 2023-04-21 |
| ANNUAL REPORT | 2022-04-22 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-04-28 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-04-02 |
| CORLCRACHG | 2017-10-05 |
| ANNUAL REPORT | 2017-04-27 |
| ANNUAL REPORT | 2016-04-15 |
Date of last update: 26 Jan 2025
Sources: Florida Department of State
