| Entity Name: | SERENITY WAY ASSISTED LIVING "LLC" |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 10 Jun 2009 (16 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | L09000056534 |
| FEI/EIN Number | 270297750 |
| Address: | 597 SW FELDMAN AVE, PORT ST. LUCIE,, FL, 34953, UN |
| Mail Address: | 597 SW FELDMAN AVE, PORT ST. LUCIE,, FL, 34953, UN |
| ZIP code: | 34953 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073805362 | 2011-05-05 | 2011-05-05 | 1120 48TH ST, WEST PALM BEACH, FL, 334072302, US | 1120 48TH ST, WEST PALM BEACH, FL, 334072302, US | |||||||||||||||||||||||||
|
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| Phone | +1 561-629-7450 |
| Fax | 5616297452 |
Authorized person
| Name | ANTHONY POITIER SR. |
| Role | ADMINISTRATOR |
| Phone | 5616297450 |
Taxonomy
| Taxonomy Code | 3104A0625X - Assisted Living Facility (Mental Illness) |
| License Number | AL11713 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 001708200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| POITIER ANTHONY V | Agent | 597 SW FELDMAN AVE, PORT ST. LUCIE, FL, 34953 |
| Name | Role | Address |
|---|---|---|
| POITIER ANTHONY V | Manager | 597 SW FELDMAN AVE, PORT ST LUCIE, FL, 34953 |
| Name | Role | Address |
|---|---|---|
| POITIER WENDY D | Managing Member | 597 SW FELDMAN AVENUE, PORT ST. LUCIE, FL, 34953 |
| POITIER SHOSHANA | Managing Member | 597 SW FELDMAN AVENUE, PORT ST. LUCIE, FL, 34953 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| REINSTATEMENT | 2011-10-06 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-10-06 | 597 SW FELDMAN AVE, PORT ST. LUCIE,, FL 34953 UN | No data |
| CHANGE OF MAILING ADDRESS | 2011-10-06 | 597 SW FELDMAN AVE, PORT ST. LUCIE,, FL 34953 UN | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| LC AMENDMENT AND NAME CHANGE | 2009-12-28 | SERENITY WAY ASSISTED LIVING "LLC" | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2011-10-06 |
| ANNUAL REPORT | 2010-05-04 |
| LC Amendment and Name Change | 2009-12-28 |
| Florida Limited Liability | 2009-06-10 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
