| Entity Name: | A SAFE HAVEN ASSISTED LIVING, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 24 Nov 2010 (14 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | L10000121961 |
| FEI/EIN Number | NOT APPLICABLE |
| Address: | 9000 86TH AVENUE, NORTH, SEMINOLE, FL, 33777 |
| Mail Address: | 5434 ADAMS MORGAN WAY, NEW PORT RICHEY, FL, 34652, US |
| ZIP code: | 33777 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003175936 | 2012-05-13 | 2012-05-13 | 9000 86TH AVE, SEMINOLE, FL, 337772641, US | 9000 86TH AVE, SEMINOLE, FL, 337772641, US | |||||||||||||||||
|
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| Phone | +1 727-623-9073 |
Authorized person
| Name | MR. MARK T HUBA |
| Role | ADMINISTRATOR |
| Phone | 7276239073 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL12103 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KAHN DONALD | Agent | 9000 86TH AVENUE, NORTH, SEMINOLE, FL, 33777 |
| Name | Role | Address |
|---|---|---|
| PEREZ MARTZA | Managing Member | 5434 ADAMS MORGAN WAY, NEW PORT RICHEY, FL, 34652 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2014-05-01 | 9000 86TH AVENUE, NORTH, SEMINOLE, FL 33777 | No data |
| REGISTERED AGENT NAME CHANGED | 2014-05-01 | KAHN, DONALD | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-05-01 | 9000 86TH AVENUE, NORTH, SEMINOLE, FL 33777 | No data |
| REINSTATEMENT | 2012-10-01 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J16000301394 | ACTIVE | 1000000712007 | PINELLAS | 2016-05-04 | 2036-05-12 | $ 300.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, LARGO SERVICE CENTER, 11351 ULMERTON RD STE 220, LARGO FL337781629 |
| J15000192639 | ACTIVE | 1000000650671 | PINELLAS | 2015-01-29 | 2035-02-05 | $ 300.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, LARGO SERVICE CENTER, 11351 ULMERTON RD STE 220, LARGO FL337781629 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2015-04-30 |
| ANNUAL REPORT | 2014-05-01 |
| ANNUAL REPORT | 2013-04-30 |
| REINSTATEMENT | 2012-10-01 |
| ANNUAL REPORT | 2011-04-30 |
| Florida Limited Liability | 2010-11-24 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
