| Entity Name: | INDIVIDUALIZED SUPPORT SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 16 Apr 2009 (16 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 06 May 2009 (16 years ago) |
| Document Number: | L09000036871 |
| FEI/EIN Number | 264681766 |
| Address: | 234 SW Starflower Avenue, Port St. Lucie, FL, 34984, US |
| Mail Address: | Post Office Box 6003, Vero Beach, FL, 32961, US |
| ZIP code: | 34984 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386970846 | 2009-10-19 | 2009-10-19 | 234 SW STARFLOWER AVE, PORT ST LUCIE, FL, 349844461, US | 1965 42ND AVE STE 3, VERO BEACH, FL, 329602502, US | |||||||||||||||||||||||||||||||
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| Phone | +1 772-696-3189 |
| Fax | 7724929147 |
| Phone | +1 772-492-9159 |
Authorized person
| Name | RENA ARLENE BAKER |
| Role | ONER |
| Phone | 7726963189 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | 001173600 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | No |
Other Provider Identifiers
| Issuer | PROVIDER NUMBER (HCBS) AND (FSL) |
| Number | 001173600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BAKER RENA A | Agent | 234 SW STARFLOWER AVE, PORT ST LUCIE, FL, 34984 |
| Name | Role | Address |
|---|---|---|
| BAKER RENA A | Manager | 234 SW STARFLOWER AVE, PORT ST. LUCIE, FL, 34984 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2020-06-29 | 234 SW Starflower Avenue, Port St. Lucie, FL 34984 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-04-26 | 234 SW Starflower Avenue, Port St. Lucie, FL 34984 | No data |
| LC AMENDMENT | 2009-05-06 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J16000730642 | LAPSED | 562015CA001355 | ST LUCIE | 2016-10-06 | 2021-11-28 | $16963.21 | CACH, LLC, 887 DONALD ROSS RD, JUNO BEACH, FL 33408 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-25 |
| ANNUAL REPORT | 2023-03-27 |
| ANNUAL REPORT | 2022-04-07 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-06-29 |
| ANNUAL REPORT | 2019-04-25 |
| ANNUAL REPORT | 2018-03-25 |
| ANNUAL REPORT | 2017-04-27 |
| ANNUAL REPORT | 2016-04-21 |
| ANNUAL REPORT | 2015-04-24 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
