| Entity Name: | SELAH-GULF BREEZE COURTYARD, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 08 Sep 2010 (14 years ago) |
| Date of dissolution: | 29 Apr 2015 (10 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 29 Apr 2015 (10 years ago) |
| Document Number: | L10000093972 |
| FEI/EIN Number | 273357044 |
| Address: | 115 Professional Drive, PONTE VEDRA BEACH, FL, 32082, US |
| Mail Address: | 115 Professional Drive, PONTE VEDRA BEACH, FL, 32082, US |
| ZIP code: | 32082 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538594577 | 2013-09-10 | 2013-09-10 | 3428 GULF BREEZE PKWY, GULF BREEZE, FL, 325631400, US | 3428 GULF BREEZE PKWY, GULF BREEZE, FL, 325631400, US | |||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 850-934-1662 |
| Fax | 8509344218 |
Authorized person
| Name | MR. ALAN DANIEL PARRISH |
| Role | MANAGER |
| Phone | 9045431818 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL9976 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | WORLDNET - MEDICAID DIVERSION PROGRAM |
| Number | 7618 |
| State | FL |
| Issuer | MEDICAID WAIVER PROGRAM |
| Number | 003102500 |
| State | FL |
| Issuer | AMERICAN ELDERCARE - MEDICAID DIVERSION PROGRAM |
| Number | 109168 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Filippone William T | Agent | 115 Professional Drive, PONTE VEDRA BEACH, FL, 32082 |
| Name | Role |
|---|---|
| SELAH SENIORCARE II, LLC | Manager |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2015-04-29 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2015-02-04 | Filippone, William T | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-01-08 | 115 Professional Drive, Suite 101, PONTE VEDRA BEACH, FL 32082 | No data |
| CHANGE OF MAILING ADDRESS | 2014-01-08 | 115 Professional Drive, Suite 101, PONTE VEDRA BEACH, FL 32082 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-01-08 | 115 Professional Drive, Suite 101, PONTE VEDRA BEACH, FL 32082 | No data |
| REINSTATEMENT | 2012-04-06 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2015-04-29 |
| ANNUAL REPORT | 2015-02-04 |
| ANNUAL REPORT | 2014-01-08 |
| ANNUAL REPORT | 2013-01-16 |
| REINSTATEMENT | 2012-04-06 |
| Florida Limited Liability | 2010-09-08 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
