| Entity Name: | FAMILY HOME CARE GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 21 Dec 2011 (13 years ago) |
| Document Number: | L11000143231 |
| FEI/EIN Number | 45-4100526 |
| Address: | 622 E. Washington St, Suite 200, ORLANDO, FL 32801 |
| Mail Address: | 622 E. Washington St, Suite 200, ORLANDO, FL 32801 |
| ZIP code: | 32801 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811254899 | 2012-04-16 | 2012-04-16 | 5401 S KIRKMAN RD, #223, ORLANDO, FL, 328197940, US | 5401 S KIRKMAN RD, #223, ORLANDO, FL, 328197940, US | |||||||||||||||||||||||||
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| Phone | +1 407-401-9146 |
| Fax | 4075174860 |
Authorized person
| Name | LEA F BALL |
| Role | OWNER/ADMINISTRATOR |
| Phone | 4074019146 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | 299993988 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AGENCY FOR HEALTH CARE ADMINISTRATION |
| Number | 299993988 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FHCG 401(K) PLAN | 2023 | 454100526 | 2024-07-23 | FAMILY HOME CARE GROUP LLC | 18 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-07-23 |
| Name of individual signing | KIMBERLY JAMES |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 621610 |
| Sponsor’s telephone number | 4074019146 |
| Plan sponsor’s address | 5401 S KIRKMAN RD, STE 510, ORLANDO, FL, 32819 |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 621610 |
| Sponsor’s telephone number | 4074019146 |
| Plan sponsor’s address | 5401 S KIRKMAN RD, STE 510, ORLANDO, FL, 32819 |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 621610 |
| Sponsor’s telephone number | 4074019146 |
| Plan sponsor’s address | 5401 S KIRKMAN RD, STE 510, ORLANDO, FL, 32819 |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 621610 |
| Sponsor’s telephone number | 4074019146 |
| Plan sponsor’s address | 5401 S KIRKMAN RD, STE 510, ORLANDO, FL, 32819 |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 621610 |
| Sponsor’s telephone number | 4074019146 |
| Plan sponsor’s address | 5401 S KIRKMAN RD, STE 510, ORLANDO, FL, 32819 |
| Name | Role | Address |
|---|---|---|
| James, Kimberly A | Agent | 622 E Washington St, Suite 200, ORLANDO, FL 32801 |
| Name | Role | Address |
|---|---|---|
| JAMES, KIMBERLY | MEMBER | 622 E. WASHINGTON STREET, ORLANDO, FL 32801 |
| POOLER, NICHOLAS K | MEMBER | 622 E. WASHINGTON STREET SUITE 200, ORLANDO, FL 32801 |
| Name | Role | Address |
|---|---|---|
| JAMES, KIMBERLY | Chief Executive Officer | 622 E. WASHINGTON STREET, ORLANDO, FL 32801 |
| Name | Role | Address |
|---|---|---|
| POOLER, NICHOLAS K | Chief Financial Officer | 622 E. WASHINGTON STREET SUITE 200, ORLANDO, FL 32801 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2025-01-15 | 622 E Washington St, Suite 200, ORLANDO, FL 32801 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-09-16 | 622 E. Washington St, Suite 200, ORLANDO, FL 32801 | No data |
| CHANGE OF MAILING ADDRESS | 2024-09-16 | 622 E. Washington St, Suite 200, ORLANDO, FL 32801 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-03-22 | James, Kimberly A | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-01-10 | 5401 SOUTH KIRKMAN ROAD, Suite 510, ORLANDO, FL 32819 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-15 |
| ANNUAL REPORT | 2024-01-30 |
| AMENDED ANNUAL REPORT | 2023-03-22 |
| ANNUAL REPORT | 2023-01-20 |
| ANNUAL REPORT | 2022-01-14 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-01-14 |
| ANNUAL REPORT | 2019-01-04 |
| ANNUAL REPORT | 2018-01-02 |
| ANNUAL REPORT | 2017-01-13 |
Date of last update: 23 Jan 2025
Sources: Florida Department of State
