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207 MARSHALL DRIVE OPERATIONS LLC

Company Details

Entity Name: 207 MARSHALL DRIVE OPERATIONS LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Company
Status: Inactive
Date Filed: 17 Nov 2011 (13 years ago)
Date of dissolution: 23 Sep 2022 (2 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 23 Sep 2022 (2 years ago)
Document Number: L11000131303
FEI/EIN Number 38-3858470
Address: 207 MARSHALL DRIVE, PERRY, FL 32347
Mail Address: 1040 CROWN POINTE PKWY,, STE 600, ATLANTA, GA 30338-4741
ZIP code: 32347
County: Taylor
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1851660500 2011-12-27 2023-11-27 207 MARSHALL DR, PERRY, FL, 323471835, US 207 MARSHALL DR, PERRY, FL, 323471835, US

Contacts

Phone +1 850-584-6334
Fax 8508381801

Authorized person

Name KENNETH USSERY
Role VP
Phone 4075711550

Taxonomy

Taxonomy Code 314000000X - Skilled Nursing Facility
License Number SNF1436096
State FL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 004387800
State FL

Agent

Name Role
CORPORATION SERVICE COMPANY Agent

MEMBER

Name Role
EPSILON HEALTH CARE PROPERTIES, LLC MEMBER

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G12000012122 MARSHALL HEALTH AND REHABILITATION CENTER EXPIRED 2012-02-03 2017-12-31 No data 207 MARSHALL DRIVE, PERRY, FL, 32347

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2022-09-23 No data No data
CHANGE OF MAILING ADDRESS 2018-06-19 207 MARSHALL DRIVE, PERRY, FL 32347 No data
CHANGE OF PRINCIPAL ADDRESS 2017-04-17 207 MARSHALL DRIVE, PERRY, FL 32347 No data
MERGER 2012-02-01 No data CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 900000119969

Documents

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 2018-04-20
ANNUAL REPORT 2017-04-17
AMENDED ANNUAL REPORT 2016-07-14
ANNUAL REPORT 2016-04-20
ANNUAL REPORT 2015-04-17
ANNUAL REPORT 2014-05-01

Date of last update: 23 Jan 2025

Sources: Florida Department of State