| Entity Name: | SHENANDOAH MEDICAL CARE CENTER "LLC" |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
SHENANDOAH MEDICAL CARE CENTER "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: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 31 Mar 2014 (11 years ago) |
| Document Number: | L14000052601 |
| FEI/EIN Number |
46-5283443
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 6234 South Congress Ave.,, LANTANA, FL, 33462, US |
| Mail Address: | PO Box 741424, BOYNTON BEACH, FL, 33474, US |
| ZIP code: | 33462 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417494154 | 2017-01-19 | 2017-01-19 | PO BOX 741424, BOYNTON BEACH, FL, 334741424, US | 6234 S CONGRESS AVE, SUITE F-1, LANTANA, FL, 334622307, US | |||||||||||||||||||||
|
|||||||||||||||||||||||||
| Phone | +1 561-619-9510 |
Authorized person
| Name | MISS JOY L FULLER |
| Role | OWNER |
| Phone | 5618537233 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | 2602122 |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 010866400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MOWETT-FULLER JOY L | President | 6234 South Congress Ave.,, LANTANA, FL, 33462 |
| FULLER Danielle G | Chief Operating Officer | 6234 South Congress Ave.,, LANTANA, FL, 33462 |
| MOWETT-FULLER JOY L | Agent | 6234 S. Congress Ave, Lanatana, FL, 33462 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-03-14 | MOWETT-FULLER, JOY L | - |
| REGISTERED AGENT ADDRESS CHANGED | 2020-03-01 | 6234 S. Congress Ave, Suite F-1, Lanatana, FL 33462 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2017-04-18 | 6234 South Congress Ave.,, Suite F-1, LANTANA, FL 33462 | - |
| CHANGE OF MAILING ADDRESS | 2016-04-10 | 6234 South Congress Ave.,, Suite F-1, LANTANA, FL 33462 | - |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-06-03 |
| ANNUAL REPORT | 2024-03-14 |
| ANNUAL REPORT | 2023-02-13 |
| ANNUAL REPORT | 2022-03-12 |
| ANNUAL REPORT | 2021-03-21 |
| ANNUAL REPORT | 2020-03-01 |
| ANNUAL REPORT | 2019-03-06 |
| ANNUAL REPORT | 2018-03-24 |
| ANNUAL REPORT | 2017-04-18 |
| ANNUAL REPORT | 2016-04-10 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 7167117410 | 2020-05-15 | 0455 | PPP | 6234 S CONGRESS AVE STE F1, LANTANA, FL, 33462-2307 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Date of last update: 01 Mar 2025
Sources: Florida Department of State
