| Entity Name: | JACKSON HEALTHCARE SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 12 Feb 2014 (11 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 26 Sep 2017 (7 years ago) |
| Document Number: | L14000024450 |
| FEI/EIN Number | 46-3617258 |
| Address: | 3107 Spring Glen Road, Ste. 211, JACKSONVILLE, FL, 32207, US |
| Mail Address: | 7055 Blanding Blvd; P.O. Box 440002, JACKSONVILLE, FL, 32244, US |
| ZIP code: | 32207 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952980567 | 2021-04-02 | 2021-04-02 | 5604 ASHLEIGH PARK DR, JACKSONVILLE, FL, 322447821, US | 5604 ASHLEIGH PARK DR, JACKSONVILLE, FL, 322447821, US | |||||||||||||||||
|
|||||||||||||||||||||
| Name | JE-JE W JACKSON |
| Role | OWNER/PROGRAM MANAGER |
| Phone | 9044283182 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 013844800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| JACKSON JE-JE W | Agent | 4455 Confederate Point Road, Jacksonville, FL, 32210 |
| Name | Role | Address |
|---|---|---|
| JACKSON JE-JE W | Manager | 5604 ASHLEIGH PARK DRIVE, JACKSONVILLE, FL, 32244 |
| Name | Role | Address |
|---|---|---|
| JACKSON LINDA T | Authorized Member | 5604 ASHLEIGH PARK DRIVE, JACKSONVILLE, FL, 32244 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000059655 | JACKSON HEALTHCARE SERVICES, LLC | ACTIVE | 2021-04-30 | 2026-12-31 | No data | 5604 ASHLEIGH PARK DRIVE, JACKSONVILLE, FL, 32244 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-01 | 4455 Confederate Point Road, Apt. 121 A, Jacksonville, FL 32210 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-11-15 | 3107 Spring Glen Road, Ste. 211, JACKSONVILLE, FL 32207 | No data |
| CHANGE OF MAILING ADDRESS | 2023-11-15 | 3107 Spring Glen Road, Ste. 211, JACKSONVILLE, FL 32207 | No data |
| REINSTATEMENT | 2017-09-26 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-09-26 | JACKSON, JE-JE W | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-01 |
| ANNUAL REPORT | 2023-04-29 |
| ANNUAL REPORT | 2022-05-01 |
| ANNUAL REPORT | 2021-04-23 |
| ANNUAL REPORT | 2020-05-10 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-05-01 |
| REINSTATEMENT | 2017-09-26 |
| ANNUAL REPORT | 2016-07-13 |
| ANNUAL REPORT | 2015-04-08 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
