| Entity Name: | 803 OAK STREET OPERATIONS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
803 OAK STREET 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: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 17 Nov 2011 (13 years ago) |
| Date of dissolution: | 23 Sep 2022 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (3 years ago) |
| Document Number: | L11000131250 |
| FEI/EIN Number |
371653900
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Mail Address: | 1040 CROWN POINTE PKWY, STE 600, ATLANTA, GA, 30338-4741, US |
| Address: | 803 OAK STREET, GREEN COVE SPRINGS, FL, 32043, US |
| ZIP code: | 32043 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356610091 | 2011-12-27 | 2023-11-27 | 803 OAK ST, GREEN COVE SPRINGS, FL, 320434317, US | 803 OAK ST, GREEN COVE SPRINGS, FL, 320434317, US | |||||||||||||||||||||||||
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| Phone | +1 904-284-5606 |
| Fax | 9042840392 |
Authorized person
| Name | KENNETH USSERY |
| Role | VP |
| Phone | 4075711550 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF1181096 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 004387500 |
| 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 |
|---|---|---|---|---|---|---|
| G12000012045 | GOVERNOR'S CREEK HEALTH AND REHABILITATION | EXPIRED | 2012-02-03 | 2017-12-31 | - | 803 OAK STREET, GREEN COVE SPRINGS, FL, 32043 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | - | - |
| CHANGE OF MAILING ADDRESS | 2018-06-19 | 803 OAK STREET, GREEN COVE SPRINGS, FL 32043 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2017-04-18 | 803 OAK STREET, GREEN COVE SPRINGS, FL 32043 | - |
| MERGER | 2012-02-01 | - | CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 900000119879 |
| Name | Date |
|---|---|
| Reg. Agent Resignation | 2023-08-08 |
| ANNUAL REPORT | 2021-04-20 |
| ANNUAL REPORT | 2020-04-20 |
| ANNUAL REPORT | 2019-04-21 |
| ANNUAL REPORT | 2018-04-23 |
| ANNUAL REPORT | 2017-04-18 |
| AMENDED ANNUAL REPORT | 2016-07-14 |
| ANNUAL REPORT | 2016-04-22 |
| ANNUAL REPORT | 2015-04-17 |
| ANNUAL REPORT | 2014-05-01 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
