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