| Entity Name: | MERCY HOME ASSISTED LIVING FACILITY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
MERCY HOME ASSISTED LIVING FACILITY, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 22 Oct 2013 (12 years ago) |
| Date of dissolution: | 28 Sep 2018 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (7 years ago) |
| Document Number: | L13000148114 |
| FEI/EIN Number |
80-0792893
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 184 SE BEECH STREET, LAKE CITY, FL, 32025 |
| Mail Address: | 184 SE BEECH STREET, LAKE CITY, FL, 32025 |
| ZIP code: | 32025 |
| County: | Columbia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306249149 | 2014-10-08 | 2014-10-13 | 184 S.E. BEECH STREET, LAKE CITY, FL, 32025, US | 184 S.E. BEECH STREET, LAKE CITY, FL, 32025, US | |||||||||||||||||||||||||
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| Phone | +1 386-487-5029 |
| Fax | 3864875029 |
Authorized person
| Name | MRS. CLARA LEE FERGUSON |
| Role | ADMINISTRATOR/OWNER |
| Phone | 3864875029 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL12314 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009258500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FERGUSON CLARA L | Managing Member | 184 SE BEECH STREET, LAKE CITY, FL, 32025 |
| FERGUSON LEONARDO M | Managing Member | 222 SAILBOAT DRIVE, NASHVILLE, FL, 37217 |
| FERGUSON CLARA L | Agent | 184 SE BEECH STREET, LAKE CITY, FL, 32025 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | - | - |
| CONVERSION | 2013-10-22 | - | CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS P12000021490. CONVERSION NUMBER 900000135169 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-02-08 |
| ANNUAL REPORT | 2016-01-26 |
| ANNUAL REPORT | 2015-04-27 |
| ANNUAL REPORT | 2014-01-13 |
| Florida Limited Liability | 2013-10-22 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
