| Entity Name: | GRACE'S SUPPORT SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 23 Oct 2012 (12 years ago) |
| Document Number: | L12000134651 |
| FEI/EIN Number | 46-1279814 |
| Address: | 15508 WILLET CT, MASCOTTE, FL 34753 |
| Mail Address: | 15508 WILLET CT, MASCOTTE, FL 34753 |
| ZIP code: | 34753 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538614540 | 2016-08-19 | 2016-08-19 | 15508 WILLET CT, MASCOTTE, FL, 347539102, US | 15508 WILLET CT, MASCOTTE, FL, 347539102, US | |||||||||||||||||||
|
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| Phone | +1 352-255-6458 |
Authorized person
| Name | MRS. NABUCHI ANDERSON |
| Role | PRESIDENT |
| Phone | 3522556458 |
Taxonomy
| Taxonomy Code | 171M00000X - Case Manager/Care Coordinator |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 004444700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ANDERSON, NABUCHI G | Agent | 15508 WILLET CT, MASCOTTE, FL 34753 |
| Name | Role | Address |
|---|---|---|
| ANDERSON, NABUCHI G | President | 15508 WILLET CT, MASCOTTE, FL 34753 |
| Name | Role | Address |
|---|---|---|
| Anderson, Anthony Alan | Manager | 15508 WILLET CT, MASCOTTE, FL 34753 |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-02-12 |
| ANNUAL REPORT | 2024-01-31 |
| ANNUAL REPORT | 2023-04-13 |
| ANNUAL REPORT | 2022-04-12 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-05-26 |
| ANNUAL REPORT | 2019-03-24 |
| ANNUAL REPORT | 2018-04-20 |
| ANNUAL REPORT | 2017-04-15 |
| ANNUAL REPORT | 2016-03-18 |
Date of last update: 23 Jan 2025
Sources: Florida Department of State
