| Entity Name: | CLEARWATER REHABILITATION CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 23 Sep 2008 (16 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 22 Feb 2016 (9 years ago) |
| Document Number: | L08000090650 |
| FEI/EIN Number | 26-3419520 |
| Address: | 1665 Palm Beach Lakes Blvd., Suite 400, West Palm Beach, FL, 33401, US |
| Mail Address: | 1665 Palm Beach Lakes Blvd., Suite 400, West Palm Beach, FL, 33401, US |
| ZIP code: | 33401 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790789675 | 2005-06-09 | 2014-02-27 | 1675 PALM BEACH LAKES BLVD, SUITE 900, WEST PALM BEACH, FL, 33401, US | 1270 TURNER ST, CLEARWATER, FL, 337565921, US | |||||||||||||||||||||||||||
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| Phone | +1 561-801-7600 |
| Phone | +1 727-443-7639 |
| Fax | 7274474852 |
Authorized person
| Name | HOWARD JAFFE |
| Role | PRESIDENT |
| Phone | 2153466454 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF1091096 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 021291100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| Jaffe Howard | Manager | 1665 Palm Beach Lakes Blvd., West Palm Beach, FL, 33401 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000108018 | CLEARWATER CENTER | ACTIVE | 2015-10-22 | 2025-12-31 | No data | 1270 TURNER STREET, CLEARWATER, FL, 33756 |
| G09090900073 | CLEARWATER CENTER | EXPIRED | 2009-03-30 | 2014-12-31 | No data | 1270 TURNER STREET, CLEARWATER, FL, 33756 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-01 | 1665 Palm Beach Lakes Blvd., Suite 400, West Palm Beach, FL 33401 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-01 | 1665 Palm Beach Lakes Blvd., Suite 400, West Palm Beach, FL 33401 | No data |
| LC STMNT OF RA/RO CHG | 2016-02-22 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-02-22 | CT CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-02-22 | 1200 SOUTH PINE ISLAND ROAD, SUITE 1550, PLANTATION, FL 33324 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-01 |
| ANNUAL REPORT | 2023-03-06 |
| ANNUAL REPORT | 2022-03-25 |
| ANNUAL REPORT | 2021-04-01 |
| ANNUAL REPORT | 2020-04-22 |
| ANNUAL REPORT | 2019-03-28 |
| ANNUAL REPORT | 2018-04-10 |
| ANNUAL REPORT | 2017-04-11 |
| ANNUAL REPORT | 2016-04-29 |
| CORLCRACHG | 2016-02-22 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
