| Entity Name: | TAVARES VILLAGE RETIREMENT COMMUNITY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 26 Nov 2012 (12 years ago) |
| Document Number: | L12000148135 |
| FEI/EIN Number | 46-1480920 |
| Address: | 901 EAST WASHINGTON ST., ORLANDO, FL, 32804 |
| Mail Address: | 901 EAST WASHINGTON ST., ORLANDO, FL, 32804 |
| ZIP code: | 32804 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730338179 | 2008-09-10 | 2013-03-20 | 901 E WASHINGTON ST, ORLANDO, FL, 328012905, US | 1501 SUNSHINE PKWY, TAVARES, FL, 327784496, US | |||||||||||||||||||
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| Phone | +1 407-454-9096 |
| Fax | 4078430407 |
Authorized person
| Name | MR. KENNETH NIELSON |
| Role | MANAGING MEMBER |
| Phone | 4074549096 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL8948 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TAVARES VILLAGE 401(K) PLAN | 2023 | 461480920 | 2024-07-22 | TAVARES VILLAGE RETIREMENT COMMUNITY, LLC | 45 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-07-22 |
| Name of individual signing | CHRIS HORNE |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Pizam Haim C | Agent | 901 EAST WASHINGTON ST., ORLANDO, FL, 32804 |
| Name | Role | Address |
|---|---|---|
| NIELSON KENNETH | Managing Member | 901 EAST WASHINGTON ST., ORLANDO, FL, 32804 |
| Name | Role | Address |
|---|---|---|
| Pizam Haim C | Manager | 507 Palmer Street, Orlando, FL, 32801 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000012830 | THE COVE AT TAVARES VILLAGE | ACTIVE | 2013-02-06 | 2028-12-31 | No data | 901 EAST WASHINGTON STREET, ORLANDO, FL, 32801 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-02-16 | Pizam, Haim Cy | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-16 |
| ANNUAL REPORT | 2023-02-08 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-01-18 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-01-12 |
| ANNUAL REPORT | 2018-03-09 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-01-26 |
| ANNUAL REPORT | 2015-01-13 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
