| Entity Name: | BREVARD HMA HOSPICE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 26 Jul 2010 (15 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 16 Nov 2023 (a year ago) |
| Document Number: | L10000078368 |
| FEI/EIN Number | 273142339 |
| Address: | 901 HUGH WALLIS ROAD SOUTH, LAFAYETTE, LA, 70508, US |
| Mail Address: | 901 HUGH WALLIS RD. SOUTH, LAFAYETTE, LA, 70508, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1740247212 | 2006-04-28 | 2024-10-08 | PO BOX 51266, LAFAYETTE, LA, 705051266, US | 8060 SPYGLASS HILL RD, VIERA, FL, 32940, US | |||||||||||||||||||||||||
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| Phone | +1 502-891-1187 |
| Fax | 5028918067 |
| Phone | +1 321-253-2222 |
| Fax | 3212558148 |
Authorized person
| Name | JOSHUA L PROFFITT |
| Role | PRESIDENT |
| Phone | 3372331307 |
Taxonomy
| Taxonomy Code | 251G00000X - Community Based Hospice Care Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 003694700 |
| State | FL |
| CIK number | Mailing Address | Business Address | Phone | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1554263 | 661 EYSTER BOULEVARD, ROCKLEDGE, FL, 32955 | 661 EYSTER BOULEVARD, ROCKLEDGE, FL, 32955 | 239-598-3131 | |||||||||||||||||||||||||
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| Form type | EFFECT |
| File number | 333-183203-46 |
| Filing date | 2012-08-30 |
| File | View File |
Filings since 2012-08-30
| Form type | 424B3 |
| File number | 333-183203-46 |
| Filing date | 2012-08-30 |
| File | View File |
Filings since 2012-08-10
| Form type | S-4 |
| File number | 333-183203-46 |
| Filing date | 2012-08-10 |
| File | View File |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| NATIONAL HEALTH INDUSTRIES, INC. | Manager | No data |
| Proffitt Joshua L | Manager | 901 HUGH WALLIS ROAD SOUTH, South Lafayette, LA, 70508 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000142753 | MEDERI CARETENDERS HOSPICE | ACTIVE | 2024-11-22 | 2029-12-31 | No data | 901 HUGH WALLIS ROAD SOUTH, LAFAYETTE, LA, 70505 |
| G21000012269 | MEDERI CARETENDERS | ACTIVE | 2021-01-25 | 2026-12-31 | No data | 901 HUGH WALLIS ROAD SOUTH, LAFAYETTE, LA, 70508 |
| G15000005442 | WUESTHOFF HEALTH SYSTEM BREVARD HOSPICE AND PALLIATIVE CARE | ACTIVE | 2015-01-15 | 2026-12-31 | No data | 901 HUGH WALLIS ROAD SOUTH, LAFAYETTE, FL, 70508 |
| G14000118575 | WUESTHOFF HEALTH SYSTEM HOSPICE | EXPIRED | 2014-11-25 | 2019-12-31 | No data | 8060 SPYGLASS HILL ROAD, VIERA, FL, 32940 |
| G14000118578 | WUESTHOFF HEALTH SYSTEM HOSPICE OF BREVARD COUNTY | EXPIRED | 2014-11-25 | 2019-12-31 | No data | 8060 SPYGLASS HILL ROAD, VIERA, FL, 32940 |
| G14000118583 | WUESTHOFF HEALTH SYSTEM HOME HEALTH & HOSPICE | EXPIRED | 2014-11-25 | 2019-12-31 | No data | 8060 SPYGLASS HILL ROAD, VIERA, FL, 32940 |
| G10000090942 | WUESTHOFF PHYSICIAN CONSULT SERVICES | EXPIRED | 2010-10-05 | 2015-12-31 | No data | 5811 PELICAN BAY BOULEVARD,SUITE 500, NAPLES, FL, 34108-2710 |
| G10000090943 | WUESTHOFF PALLIATIVE PHYSICIAN SERVICES | EXPIRED | 2010-10-05 | 2015-12-31 | No data | 5811 PELICAN BAY BOULEVARD,SUITE 500, NAPLES, FL, 34108-2710 |
| G10000090476 | WUESTHOFF HOSPICE & PALLIATIVE CARE | EXPIRED | 2010-10-04 | 2015-12-31 | No data | 5811 PELICAN BAY BOULEVARD, SUITE 500, NAPLES, FL, 34108-2710 |
| G10000090478 | WUESTHOFF BREVARD HOSPICE | EXPIRED | 2010-10-04 | 2015-12-31 | No data | 5811 PELICAN BAY BOULEVARD, SUITE 500, NAPLES, FL, 34108-2710 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC STMNT OF RA/RO CHG | 2023-11-16 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-11-16 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-11-16 | C T CORPORATION SYSTEM | No data |
| LC AMENDMENT | 2020-01-21 | No data | No data |
| LC AMENDMENT | 2018-12-07 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2018-12-05 | 901 HUGH WALLIS ROAD SOUTH, LAFAYETTE, LA 70508 | No data |
| LC AMENDMENT | 2018-12-05 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-11-30 | 901 HUGH WALLIS ROAD SOUTH, LAFAYETTE, LA 70508 | No data |
| LC AMENDMENT | 2018-11-30 | No data | No data |
| LC STMNT OF RA/RO CHG | 2017-03-02 | No data | No data |
| Title | Case Number | Docket Date | Status | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Brevard HMA Hospice, LLC, Appellant(s) v. VNA Hospice of Indian River County, Inc., Agency for Health Care Administration, Appellee(s). | 1D2024-2483 | 2024-09-30 | Open | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Name | BREVARD HMA HOSPICE, LLC |
| Role | Appellant |
| Status | Active |
| Representations | Geoffrey Duane Smith, Sabrina Barker Dieguez, Stephen Bruce Burch |
| Name | VNA HOSPICE OF INDIAN RIVER COUNTY, INC. |
| Role | Appellee |
| Status | Active |
| Representations | Kristen Dobson, Seann Michael Frazier |
| Name | AHCA Agency Clerk |
| Role | Lower Tribunal Clerk |
| Status | Active |
| Representations | Jason Collins Weida |
| Name | Agency for Health Care Administration |
| Role | Appellee |
| Status | Active |
| Representations | Andrew Taylor Sheeran, Doyle Carlton Enfinger, II, Julia Elizabeth Smith, Tracy Lee Cooper George, Stephanie Elona Novenario |
Docket Entries
| Docket Date | 2024-11-19 |
| Type | Notice |
| Subtype | Notice of Agreed Extension of Time - Initial Brief |
| Description | Notice of Agreed Extension of Time - Initial Brief - 90 days 3/6/25 |
| On Behalf Of | Brevard HMA Hospice, LLC |
| Docket Date | 2024-11-15 |
| Type | Record |
| Subtype | Transcript Redacted |
| Description | Transcript Redacted - 2121 pages |
| Docket Date | 2024-11-13 |
| Type | Record |
| Subtype | Record on Appeal Redacted |
| Description | Record on Appeal Redacted - 4755 pages |
| Docket Date | 2024-10-30 |
| Type | Record |
| Subtype | Index |
| Description | Index |
| On Behalf Of | AHCA Agency Clerk |
| Docket Date | 2024-10-25 |
| Type | Misc. Events |
| Subtype | Docketing Statement |
| Description | Docketing Statement |
| On Behalf Of | Brevard HMA Hospice, LLC |
| Docket Date | 2024-10-15 |
| Type | Misc. Events |
| Subtype | Docketing Statement |
| Description | Docketing Statement |
| On Behalf Of | Brevard HMA Hospice, LLC |
| Docket Date | 2024-10-02 |
| Type | Event |
| Subtype | Fee Paid in Full |
| Description | Fee Paid in Full |
| View | View File |
| Docket Date | 2024-10-02 |
| Type | Order |
| Subtype | Order on Filing Fee |
| Description | Order on Filing Fee |
| View | View File |
| Docket Date | 2024-10-01 |
| Type | Notice |
| Subtype | Notice of Appearance |
| Description | Notice of Appearance |
| On Behalf Of | Agency for Health Care Administration |
| Docket Date | 2024-09-30 |
| Type | Notice |
| Subtype | Notice of Appeal |
| Description | Notice of Appeal; order appealed attached |
| On Behalf Of | Brevard HMA Hospice, LLC |
| Docket Date | 2024-09-30 |
| Type | Letter |
| Subtype | Acknowledgment Letter |
| Description | Acknowledgment Letter |
| View | View File |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-04-25 |
| ANNUAL REPORT | 2024-04-16 |
| CORLCRACHG | 2023-11-16 |
| ANNUAL REPORT | 2023-04-21 |
| ANNUAL REPORT | 2022-04-24 |
| ANNUAL REPORT | 2021-04-28 |
| ANNUAL REPORT | 2020-04-28 |
| LC Amendment | 2020-01-21 |
| ANNUAL REPORT | 2019-05-01 |
| LC Amendment | 2018-12-07 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
