| Entity Name: | NELISHA FAMILY HOME, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 01 Jun 2012 (13 years ago) |
| Date of dissolution: | 25 Sep 2020 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 years ago) |
| Document Number: | L12000074002 |
| FEI/EIN Number | 32-0380797 |
| Address: | 3871 RAMSPECK STREET, PORT ST. LUCIE, FL 34953 |
| Mail Address: | 3871 RAMSPECK STREET, PORT ST. LUCIE, FL 34953 |
| ZIP code: | 34953 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134563562 | 2013-04-29 | 2018-12-14 | 3871 SW RAMSPECK ST, PORT ST LUCIE, FL, 34953, US | 3871 SW RAMSPECK ST, PORT ST LUCIE, FL, 34953, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 772-340-4671 |
| Fax | 7722640592 |
Authorized person
| Name | MS. MONICA W. BROWN |
| Role | ADMINISTRATOR |
| Phone | 7723404671 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | 12437 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | 12692 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 310400000X - Assisted Living Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | FL024319000 |
| State | FL |
| Name | Role |
|---|---|
| NELISHA FAMILY HOME, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| BROWN, MONICA W | Manager | 3871 RAMSPECK STREET, PORT ST. LUCIE, FL 34953 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000047686 | NELISHA FAMILY HOME II ALF | EXPIRED | 2015-05-13 | 2020-12-31 | No data | 1243 SW FOX COURT, PORT ST. LUCIE, FL, 34953 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2016-02-23 | 3871 RAMSPECK STREET, PORT ST. LUCIE, FL 34953 | No data |
| REGISTERED AGENT NAME CHANGED | 2014-07-19 | Nelisha Family Home, LLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-07-19 | 3871 RAMSPECK STREET, PORT ST. LUCIE, FL 34953 | No data |
| REINSTATEMENT | 2013-10-08 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-02-15 |
| ANNUAL REPORT | 2018-02-12 |
| ANNUAL REPORT | 2017-04-27 |
| ANNUAL REPORT | 2016-02-23 |
| ANNUAL REPORT | 2015-02-21 |
| ANNUAL REPORT | 2014-07-19 |
| REINSTATEMENT | 2013-10-08 |
| Florida Limited Liability | 2012-06-01 |
Date of last update: 22 Feb 2025
Sources: Florida Department of State
