| Entity Name: | COMMON SPRINGS SUPPORT SERVICES L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 30 Jan 2012 (13 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | L12000013420 |
| FEI/EIN Number | 45-4382519 |
| Address: | 6188 SHARON CT, RIDGE MANOR, FL, 33597, US |
| Mail Address: | P.O.Box 994, Lacoochee, FL, 33537, US |
| ZIP code: | 33597 |
| County: | Sumter |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033546270 | 2013-10-02 | 2013-10-02 | PO BOX 994, LACOOCHEE, FL, 335370994, US | 6188 SHARON CT, WEBSTER, FL, 335979700, US | |||||||||||||||||||||||||||||
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| Phone | +1 352-583-3634 |
Authorized person
| Name | MRS. TERMINA WILLIAMS |
| Role | OWNER |
| Phone | 3525833634 |
Taxonomy
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| License Number | 232848 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 005443200 |
| State | FL |
| Issuer | MEDICAID |
| Number | 006787600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WILLIAMS TERMINA L | Agent | 6188 SHARON CT, RIDGE MANOR, FL, 33597 |
| Name | Role | Address |
|---|---|---|
| WILLIAMS TERMINA L | Managing Member | 6188 SHARON CT, RIDGE MANOR, FL, 33597 |
| Name | Role | Address |
|---|---|---|
| JOHNSON LOTTIE S | Manager | 6234 31ST ST. SO., ST. PETERSBURG, FL, 33712 |
| WILLIAMS GREGORY L | Manager | 34320 RIDGE MANOR BLVD, RIDGE MANOR, FL, 33523 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2014-04-30 | WILLIAMS, TERMINA L | No data |
| CHANGE OF MAILING ADDRESS | 2013-04-29 | 6188 SHARON CT, RIDGE MANOR, FL 33597 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-04-30 |
| ANNUAL REPORT | 2013-04-29 |
| Florida Limited Liability | 2012-01-30 |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
