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15204 WEST COLONIAL DRIVE OPERATIONS LLC - Florida Company Profile

Company Details

Entity Name: 15204 WEST COLONIAL DRIVE OPERATIONS LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

15204 WEST COLONIAL DRIVE OPERATIONS LLC 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.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

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: 17 Nov 2011 (13 years ago)
Last Event: CORPORATE MERGER
Event Date Filed: 01 Feb 2012 (13 years ago)
Document Number: L11000131222
FEI/EIN Number 371653462

Federal Employer Identification (FEI) Number assigned by the IRS.

Mail Address: 1040 CROWN POINTE PKWY STE 600, ATLANTA, GA, 30338-4741, US
Address: 850 CONCOURSE PKWY, STE 250, MAITLAND, FL, 32751, US
ZIP code: 32751
County: Orange
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1831468610 2011-12-22 2023-11-27 15204 W COLONIAL DR, WINTER GARDEN, FL, 347876042, US 15204 W COLONIAL DR, WINTER GARDEN, FL, 347876042, US

Contacts

Phone +1 407-877-2394
Fax 4078776143

Authorized person

Name KENNETH USSERY
Role VP
Phone 4075711550

Taxonomy

Taxonomy Code 314000000X - Skilled Nursing Facility
License Number SNF1610096
State FL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 004385400
State FL

Key Officers & Management

Name Role
EPSILON HEALTH CARE PROPERTIES, LLC Member
CORPORATION SERVICE COMPANY Agent

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G12000011996 COLONIAL LAKES HEALTH CARE ACTIVE 2012-02-03 2027-12-31 - 1040 CROWN POINTE PARKWAY, SUITE 600, ATLANTA, GA, 30338

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-04-23 850 CONCOURSE PKWY, STE 250, MAITLAND, FL 32751 -
CHANGE OF MAILING ADDRESS 2018-06-19 850 CONCOURSE PKWY, STE 250, MAITLAND, FL 32751 -
REGISTERED AGENT NAME CHANGED 2012-03-20 CORPORATION SERVICE COMPANY -
REGISTERED AGENT ADDRESS CHANGED 2012-03-20 1201 HAYS STREET, TALLAHASSEE, FL 32301-2525 -
MERGER 2012-02-01 - CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 500000119925

Documents

Name Date
ANNUAL REPORT 2024-04-23
ANNUAL REPORT 2023-04-25
ANNUAL REPORT 2022-04-28
ANNUAL REPORT 2021-04-21
ANNUAL REPORT 2020-04-20
ANNUAL REPORT 2019-04-21
ANNUAL REPORT 2018-04-19
ANNUAL REPORT 2017-04-17
AMENDED ANNUAL REPORT 2016-07-14
ANNUAL REPORT 2016-04-19

Date of last update: 01 Mar 2025

Sources: Florida Department of State