| Entity Name: | PEACEFUL SPIRIT HOME HEALTHCARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 27 Jun 2011 (14 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 15 May 2024 (9 months ago) |
| Document Number: | L11000074402 |
| FEI/EIN Number | 452638403 |
| Address: | 7827 North Dale Mabry Hwy, Suite 106, Tampa, FL, 33614, US |
| Mail Address: | 7827 North Dale Mabry Hwy, Suite 106, Tampa, FL, 33614, US |
| ZIP code: | 33614 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710274329 | 2011-07-03 | 2023-02-09 | 13907 N DALE MABRY HWY STE 214, TAMPA, FL, 336182411, US | 7827 N DALE MABRY HWY STE 106, TAMPA, FL, 336143222, US | |||||||||||||||||||||
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| Phone | +1 813-960-5575 |
| Fax | 8139605576 |
Authorized person
| Name | YOEL LEYVA |
| Role | PRESIDENT |
| Phone | 8139605575 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009328700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LEYVA YOEL | Agent | 5814 N CAMERON AVE, TAMPA, FL, 33614 |
| Name | Role | Address |
|---|---|---|
| LEYVA YOEL | Authorized Member | 5814 N CAMERON AVE, TAMPA, FL, 33614 |
| DIAZ DE VILLEGAS LAURA | Authorized Member | 4715 KELLY RD, TAMPA, FL, 33615 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G25000005059 | ACTIVA HOME HEALTH SERVICES | ACTIVE | 2025-01-11 | 2030-12-31 | No data | 7827 N DALE MABRY HWY, SUITE 106, TAMPA, FL, 33614 |
| G25000005061 | ACTIVA HOME HEALTH CARE | ACTIVE | 2025-01-11 | 2030-12-31 | No data | 7827 N DALE MABRY HWY, SUITE 106, TAMPA, FL, 33614 |
| G25000005062 | ACTIVA HOME HEALTH | ACTIVE | 2025-01-11 | 2030-12-31 | No data | 7827 N DALE MABRY HWY, SUITE 106, TAMPA, FL, 33614 |
| G25000003723 | AT-HOME HEALTH SERVICES | ACTIVE | 2025-01-08 | 2030-12-31 | No data | 7827 N DALE MABRY HWY, SUITE 106, TAMPA, FL, 33614 |
| G25000003725 | AT HOME HEALTH SERVICES | ACTIVE | 2025-01-08 | 2030-12-31 | No data | 7827 N DALE MABRY HWY, SUITE 106, TAMPA, FL, 33614 |
| G11000066040 | PEACEFUL SPIRIT HOME HEALTHCARE | EXPIRED | 2011-06-30 | 2016-12-31 | No data | 207 EAST ROBERTSON STREET, STE. E, BRANDON, FL, 33511 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2024-05-15 | No data | No data |
| LC AMENDMENT | 2022-01-27 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2022-01-27 | 7827 North Dale Mabry Hwy, Suite 106, Tampa, FL 33614 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-01-27 | 7827 North Dale Mabry Hwy, Suite 106, Tampa, FL 33614 | No data |
| LC AMENDMENT | 2021-09-09 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2021-07-27 | LEYVA, YOEL | No data |
| LC AMENDMENT | 2021-07-27 | No data | No data |
| LC AMENDMENT | 2021-06-02 | No data | No data |
| LC DISSOCIATION MEM | 2017-12-04 | No data | No data |
| LC DISSOCIATION MEM | 2017-11-06 | No data | No data |
| Name | Date |
|---|---|
| LC Amendment | 2024-05-15 |
| ANNUAL REPORT | 2024-04-16 |
| ANNUAL REPORT | 2023-04-20 |
| ANNUAL REPORT | 2022-03-07 |
| LC Amendment | 2022-01-27 |
| LC Amendment | 2021-09-09 |
| LC Amendment | 2021-07-27 |
| LC Amendment | 2021-06-02 |
| ANNUAL REPORT | 2021-03-23 |
| AMENDED ANNUAL REPORT | 2020-10-06 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
