| Entity Name: | PETERSON FAMILY CARE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 12 Aug 2013 (11 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 27 Feb 2015 (10 years ago) |
| Document Number: | L13000113486 |
| FEI/EIN Number | 46-3175563 |
| Address: | 3507 Lee Blvd., Suite 273, LEHIGH ACRES, FL, 33971, US |
| Mail Address: | 3507 Lee Blvd., Suite 273, LEHIGH ACRES, FL, 33917, US |
| ZIP code: | 33971 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962979369 | 2018-10-24 | 2022-01-28 | 3507 LEE BLVD STE 273, LEHIGH ACRES, FL, 339711323, US | 3507 LEE BLVD STE 273, LEHIGH ACRES, FL, 339711323, US | |||||||||||||||||||||||||
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| Phone | +1 239-770-4235 |
| Fax | 8882030442 |
Authorized person
| Name | CHEVONE L. PETERSON |
| Role | DIRECTOR |
| Phone | 2397704235 |
Taxonomy
| Taxonomy Code | 251C00000X - Developmentally Disabled Services Day Training Agency |
| Is Primary | No |
| Taxonomy Code | 342000000X - Transportation Network Company |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009279700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GRAHAM PETERSON CHEVONE L | Agent | 3507 Lee Blvd., Suite 273, LEHIGH ACRES, FL, 33971 |
| Name | Role | Address |
|---|---|---|
| GRAHAM PETERSON CHEVONE L | Chief Executive Officer | 3507 Lee Blvd., Suite 273, LEHIGH ACRES, FL, 33971 |
| Name | Role | Address |
|---|---|---|
| PETERSON JAMES E | Manager | 3507 Lee Blvd., Suite 273, LEHIGH ACRES, FL, 33971 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000100821 | PFC TRANSPORTATION | ACTIVE | 2021-08-02 | 2026-12-31 | No data | 3507 LEE BLVD SUITE 273, LEHIGH ACRES, FL, 33971 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-04-19 | GRAHAM PETERSON, CHEVONE L | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-04-12 | 3507 Lee Blvd., Suite 273, LEHIGH ACRES, FL 33971 | No data |
| CHANGE OF MAILING ADDRESS | 2018-04-12 | 3507 Lee Blvd., Suite 273, LEHIGH ACRES, FL 33971 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-04-12 | 3507 Lee Blvd., Suite 273, LEHIGH ACRES, FL 33971 | No data |
| REINSTATEMENT | 2015-02-27 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-19 |
| ANNUAL REPORT | 2022-04-16 |
| ANNUAL REPORT | 2021-04-08 |
| ANNUAL REPORT | 2020-05-13 |
| ANNUAL REPORT | 2019-04-11 |
| ANNUAL REPORT | 2018-04-12 |
| ANNUAL REPORT | 2017-04-05 |
| ANNUAL REPORT | 2016-04-18 |
| REINSTATEMENT | 2015-02-27 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
