| Entity Name: | TIDEWELL HOME HEALTH, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 05 May 2010 (15 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 26 Apr 2017 (8 years ago) |
| Document Number: | L10000048810 |
| FEI/EIN Number | 272514246 |
| Address: | 6310 Capital Drive, BRADENTON, FL, 34202, US |
| Mail Address: | 6310 Capital Drive, Lakewood Ranch, FL, 34202, US |
| ZIP code: | 34202 |
| County: | Manatee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033873112 | 2021-10-26 | 2024-01-11 | 5955 RAND BLVD, SARASOTA, FL, 342385160, US | 5955 RAND BLVD, SARASOTA, FL, 342385160, US | |||||||||||||||||||||||||||
|
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| Phone | +1 941-552-7544 |
Authorized person
| Name | SAIDA BOUHAMID |
| Role | CFO |
| Phone | 9415527500 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| Is Primary | No |
| Taxonomy Code | 3747A0650X - Attendant Care Provider |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 002597100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HENDRICKS CHRISTY | Agent | 6310 Capital Drive, Suite 110, BRADENTON, FL, 34202 |
| Name | Role | Address |
|---|---|---|
| Fleece Jonathan D | Chief Executive Officer | 6310 Capital Drive, BRADENTON, FL, 34202 |
| Name | Role | Address |
|---|---|---|
| BOUHAMID SAIDA | Chief Financial Officer | 6310 Capital Drive, BRADENTON, FL, 34202 |
| Name | Role | Address |
|---|---|---|
| HENDRICKS CHRISTY | Chief Learning Officer | 6310 Capital Drive, BRADENTON, FL, 34202 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000127199 | EMPATH PERSONAL CARE | ACTIVE | 2021-09-23 | 2026-12-31 | No data | 5955 RAND BLVD., SARASOTA, FL, 34238 |
| G11000003938 | APPROVED HOME HEALTH | EXPIRED | 2011-01-07 | 2016-12-31 | No data | 5955 RAND BLVD., SARASOTA, FL, 34238 |
| G10000061320 | APPROVED HOME HEALTH | ACTIVE | 2010-07-02 | 2025-12-31 | No data | 5955 RAND BLVD., SARASOTA, FL, 34238 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-25 | 6310 Capital Drive, BRADENTON, FL 34202 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-25 | 6310 Capital Drive, BRADENTON, FL 34202 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-04-25 | HENDRICKS, CHRISTY | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-25 | 6310 Capital Drive, Suite 110, BRADENTON, FL 34202 | No data |
| LC AMENDMENT | 2017-04-26 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| AMENDED ANNUAL REPORT | 2023-10-09 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-04-25 |
| ANNUAL REPORT | 2021-03-26 |
| AMENDED ANNUAL REPORT | 2020-12-09 |
| ANNUAL REPORT | 2020-03-18 |
| ANNUAL REPORT | 2019-04-09 |
| ANNUAL REPORT | 2018-01-18 |
| LC Amendment | 2017-04-26 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
