Entity Name: | PACIFICA CARE PLLC |
Jurisdiction: | FLORIDA |
Filing Type: |
Florida Limited Liability Co.
PACIFICA CARE PLLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
Date Filed: | 28 Sep 2010 (14 years ago) |
Last Event: | LC AMENDMENT |
Event Date Filed: | 30 Sep 2011 (13 years ago) |
Document Number: | L10000100991 |
FEI/EIN Number |
273561637
Federal Employer Identification (FEI) Number assigned by the IRS. |
Address: | 13121 ATLANTIC BLVD.,, SUITE 100, JACKSONVILLE, FL, 32225, US |
Mail Address: | 13121 ATLANTIC BLVD.,, SUITE 100, JACKSONVILLE, FL, 32225, US |
ZIP code: | 32225 |
County: | Duval |
Place of Formation: | FLORIDA |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1669775037 | 2010-12-07 | 2012-01-10 | 13121 ATLANTIC BLVD, SUITE 100, JACKSONVILLE, FL, 32225, US | 13121 ATLANTIC BLVD, SUITE 100, JACKSONVILLE, FL, 32225, US | |||||||||||||||||||||||||||||||||
|
Phone | +1 904-221-2232 |
Fax | 9042212205 |
Authorized person
Name | PEGGY A ARCANZ |
Role | ADMINISTRATOR |
Phone | 9042212232 |
Taxonomy
Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
License Number | 9102783 |
State | FL |
Is Primary | No |
Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
License Number | HCC8789 |
State | FL |
Is Primary | Yes |
Other Provider Identifiers
Issuer | MEDICAID |
Number | 292650400 |
State | FL |
Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
PACIFICA CARE 401(K) PLAN | 2023 | 273561637 | 2024-04-30 | PACIFICA CARE PLLC | 42 | |||||||||||||||||||||||||||||||
|
Administrator’s EIN | 474474775 |
Plan administrator’s name | GUIDELINE, INC. |
Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
Administrator’s telephone number | 8882283491 |
Signature of
Role | Plan administrator |
Date | 2024-04-30 |
Name of individual signing | QIAN LIU |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 001 |
Effective date of plan | 2022-01-01 |
Business code | 621112 |
Sponsor’s telephone number | 9042212232 |
Plan sponsor’s address | 13121 ATLANTIC BLVD # 100, JACKSONVILLE, FL, 32225 |
Plan administrator’s name and address
Administrator’s EIN | 474474775 |
Plan administrator’s name | GUIDELINE, INC. |
Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
Administrator’s telephone number | 8882283491 |
Signature of
Role | Plan administrator |
Date | 2023-05-27 |
Name of individual signing | CHRISTINE RIMER |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 001 |
Effective date of plan | 2011-01-01 |
Business code | 621111 |
Sponsor’s telephone number | 9042212232 |
Plan sponsor’s address | 13121 ATLANTIC BLVD SUITE 100, JACKSONVILLE, FL, 32225 |
Signature of
Role | Plan administrator |
Date | 2014-10-02 |
Name of individual signing | DONNA BELLINGER-TREESH |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 001 |
Effective date of plan | 2011-01-01 |
Business code | 621111 |
Sponsor’s telephone number | 9042212232 |
Plan sponsor’s address | 13121 ATLANTIC BLVD SUITE 100, JACKSONVILLE, FL, 32225 |
Signature of
Role | Plan administrator |
Date | 2014-11-17 |
Name of individual signing | DONNA BELLINGER-TREESH |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 001 |
Effective date of plan | 2011-01-01 |
Business code | 621111 |
Sponsor’s telephone number | 9042212232 |
Plan sponsor’s address | 13121 ATLANTIC BLVD SUITE 100, JACKSONVILLE, FL, 32225 |
Plan administrator’s name and address
Administrator’s EIN | 273561637 |
Plan administrator’s name | PACIFICA CARE PLLC |
Plan administrator’s address | 13121 ATLANTIC BLVD SUITE 100, JACKSONVILLE, FL, 32225 |
Administrator’s telephone number | 9042212232 |
Signature of
Role | Plan administrator |
Date | 2012-07-02 |
Name of individual signing | PACIFICA CARE PLLC |
Valid signature | Filed with authorized/valid electronic signature |
Name | Role | Address |
---|---|---|
BELLINGER TREESH DONNA | Managing Member | 13121 ATLANTIC BLVD., SUITE 100, JACKSONVILLE, FL, 32225 |
TREESH GABRIEL | Managing Member | 13121 ATLANTIC BLVD., SUITE 100, JACKSONVILLE, FL, 32225 |
BELLINGER TREESH DONNA | Agent | 13121 ATLANTIC BLVD.,, JACKSONVILLE, FL, 32225 |
Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
---|---|---|---|---|---|---|
G18000061771 | PACIFICA CARE OF SUNCOAST | ACTIVE | 2018-05-23 | 2028-12-31 | - | 24451 SANDHILL BLVD UNIT B, PUNTA GORDA, FL, 33983 |
G11000078218 | PACIFICA CARE MIND & BODY WELLNESS CLINIC | EXPIRED | 2011-08-05 | 2016-12-31 | - | 13111 ATLANTIC BLVD, STE 2, JACKSONVILLE, FL, 32225 |
Event Type | Filed Date | Value | Description |
---|---|---|---|
CHANGE OF PRINCIPAL ADDRESS | 2012-03-22 | 13121 ATLANTIC BLVD.,, SUITE 100, JACKSONVILLE, FL 32225 | - |
CHANGE OF MAILING ADDRESS | 2012-03-22 | 13121 ATLANTIC BLVD.,, SUITE 100, JACKSONVILLE, FL 32225 | - |
REGISTERED AGENT ADDRESS CHANGED | 2012-03-22 | 13121 ATLANTIC BLVD.,, SUITE 100, JACKSONVILLE, FL 32225 | - |
LC AMENDMENT | 2011-09-30 | - | - |
LC AMENDMENT | 2011-06-22 | - | - |
LC AMENDMENT | 2010-10-27 | - | - |
Name | Date |
---|---|
ANNUAL REPORT | 2024-02-13 |
ANNUAL REPORT | 2023-03-15 |
ANNUAL REPORT | 2022-03-02 |
ANNUAL REPORT | 2021-01-29 |
ANNUAL REPORT | 2020-05-13 |
ANNUAL REPORT | 2019-04-09 |
ANNUAL REPORT | 2018-04-24 |
ANNUAL REPORT | 2017-07-07 |
ANNUAL REPORT | 2016-03-18 |
ANNUAL REPORT | 2015-03-13 |
Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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1076708806 | 2021-04-09 | 0491 | PPS | 13121 Atlantic Blvd Ste 100, Jacksonville, FL, 32225-0102 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Mar 2025
Sources: Florida Department of State