| Entity Name: | AFFIANCE HEALTH CARE SERVICES, LLC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 05 Jan 2009 (16 years ago) |
| Date of dissolution: | 04 Dec 2014 (10 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 04 Dec 2014 (10 years ago) |
| Document Number: | L09000000751 |
| FEI/EIN Number | 263956728 |
| Address: | 6015 CHESTER CIRCLE, SUITE 104, JACKSONVILLE, FL, 33217 |
| Mail Address: | 6015 CHESTER CIRCLE, SUITE 104, JACKSONVILLE, FL, 33217 |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598096604 | 2010-01-29 | 2010-08-20 | 6015 CHESTER CIRCLE STE 104, JACKSONVILLE, FL, 322172265, US | 6015 CHESTER CIRCLE STE 104, JACKSONVILLE, FL, 322172265, US | |||||||||||||||||||||||||||
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| Phone | +1 904-683-8666 |
| Fax | 9046838672 |
| Fax | 9046838666 |
Authorized person
| Name | MRS. RUGIATU MANSARAY |
| Role | ADMINISTRTOR/D.O.N |
| Phone | 9046838666 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | 299993654 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 001433200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MANSARAY HASSAN | Agent | 6015 CHESTER CIRCLE, JACKSONVILLE, FL, 32217 |
| Name | Role | Address |
|---|---|---|
| MANSARAY HASSAN | Manager | 6015 CHESTER CIRCLE, SUITE 104, JACKSONVILLE, FL, 32217 |
| MANSARAY RUGIATU | Manager | 6015 CHESTER CIRCLE, SUITE 104, JACKSONVILLE, FL, 32217 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2014-12-04 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-04-01 | 6015 CHESTER CIRCLE, SUITE 104, JACKSONVILLE, FL 33217 | No data |
| CHANGE OF MAILING ADDRESS | 2011-04-01 | 6015 CHESTER CIRCLE, SUITE 104, JACKSONVILLE, FL 33217 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-04-01 | 6015 CHESTER CIRCLE, SUITE 104, JACKSONVILLE, FL 32217 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2014-12-04 |
| ANNUAL REPORT | 2014-03-03 |
| ANNUAL REPORT | 2013-04-22 |
| ANNUAL REPORT | 2012-03-16 |
| ANNUAL REPORT | 2011-04-01 |
| ANNUAL REPORT | 2010-03-02 |
| Florida Limited Liability | 2009-01-05 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
