| Entity Name: | MARY MATHEWS SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 02 Dec 2013 (11 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 15 Jun 2020 (5 years ago) |
| Document Number: | L13000166523 |
| FEI/EIN Number | 26-0889867 |
| Mail Address: | 182 SPARKLEBERRY BLVD S, QUINCY, FL, 32351 |
| Address: | 182 Sparkleberry Blvd S, SUITE1, QUINCY, FL, 32351, US |
| ZIP code: | 32351 |
| County: | Gadsden |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447671094 | 2013-12-29 | 2013-12-29 | 215 W JEFFERSON ST, QUINCY, FL, 323512361, US | 215 W JEFFERSON ST, QUINCY, FL, 323512361, US | |||||||||||||||||||||||||
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| Phone | +1 850-556-2303 |
| Fax | 8506271992 |
Authorized person
| Name | MARY ANNE MATHEWS |
| Role | PRESIDENT |
| Phone | 8505562303 |
Taxonomy
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| License Number | 233422 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 003090200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Mathews Mary | Agent | 182 SPARKLEBERRY BLVD S, QUINCY, FL, 32351 |
| Name | Role | Address |
|---|---|---|
| MATHEWS MARY A | Manager | 182 SPARKLEBERRY BLVD S, QUINCY, FL, 32351 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000081018 | GENESIS SUPPORT CENTER/ ADT PROGRAM | ACTIVE | 2024-07-06 | 2029-12-31 | No data | 182 SPARKLEBERRY BLVD, QUINCY, FL, 32351--728 |
| G13000118571 | COMPANIONS "R" US | EXPIRED | 2013-12-05 | 2018-12-31 | No data | 182 SPARKLEBERRY BLVD S, QUINCY, FL, 32351 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2020-06-15 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-06-15 | 182 Sparkleberry Blvd S, SUITE1, QUINCY, FL 32351 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-06-15 | Mathews, Mary | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J23000043331 | TERMINATED | 18-253-1A-OPA | LEON | 2022-10-21 | 2028-02-01 | $29,352.97 | DFS DIVISION OF WORKERS COMPENSATION, 200 EAST GAINES STREET, TALLAHASSSEE, FLORIDA 32399 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-05-01 |
| ANNUAL REPORT | 2022-04-30 |
| ANNUAL REPORT | 2021-04-30 |
| REINSTATEMENT | 2020-06-15 |
| Florida Limited Liability | 2013-12-02 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
