| Entity Name: | SEACREST RESIDENCE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 12 May 2010 (15 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | L10000051118 |
| FEI/EIN Number | 38-3826182 |
| Address: | 144 SE 31ST AVENUE, BOYNTON BEACH, FL 33435 |
| Mail Address: | 144 SE 31ST AVENUE, BOYNTON BEACH, FL 33435 |
| ZIP code: | 33435 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356715734 | 2015-11-22 | 2015-11-22 | 144 SE 31ST AVE, BOYNTON BEACH, FL, 334358227, US | 144 SE 31ST AVE, BOYNTON BEACH, FL, 334358227, US | |||||||||||||||||||||||
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| Phone | +1 561-577-3589 |
Authorized person
| Name | ARLENE HENRY |
| Role | MANAGER |
| Phone | 5615773589 |
Taxonomy
| Taxonomy Code | 311ZA0620X - Adult Care Home Facility |
| License Number | 091916 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 014795000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HENRY, ARLENE | Agent | 144 SE 31ST AVENUE, BOYNTON BEACH, FL 33435 |
| Name | Role | Address |
|---|---|---|
| HENRY, ARLENE | Manager | 144 SE 31ST AVENUE, BOYNTON BEACH, FL 33435 |
| Anderson, Andre | Manager | 144 SE 31ST AVENUE, BOYNTON BEACH, FL 33435 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-04-16 |
| ANNUAL REPORT | 2020-09-10 |
| ANNUAL REPORT | 2019-04-24 |
| ANNUAL REPORT | 2018-04-11 |
| AMENDED ANNUAL REPORT | 2017-08-01 |
| ANNUAL REPORT | 2017-04-11 |
| ANNUAL REPORT | 2016-04-29 |
| AMENDED ANNUAL REPORT | 2015-12-20 |
| ANNUAL REPORT | 2015-04-16 |
| ANNUAL REPORT | 2014-04-28 |
Date of last update: 25 Jan 2025
Sources: Florida Department of State
