| Entity Name: | FMHR LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
FMHR 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: | 21 Aug 2014 (11 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 25 Sep 2023 (2 years ago) |
| Document Number: | L14000131304 |
| FEI/EIN Number |
47-1635834
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 390 NE 135th Street, Miami, FL, 33161, US |
| Mail Address: | 390 NE 135th Street, Miami, FL, 33161, US |
| ZIP code: | 33161 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720495120 | 2014-07-17 | 2014-11-24 | 390 NE 135TH ST, NORTH MIAMI, FL, 331613967, US | 390 NE 135TH ST, NORTH MIAMI, FL, 331613967, US | |||||||||||||||||||||||||
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| Phone | +1 305-895-4804 |
| Fax | 3058927411 |
Authorized person
| Name | SAMUEL CHAVIN |
| Role | ADMINISTRATOR |
| Phone | 3058954804 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF1163096 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 013244900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| INCORP SERVICES, INC. | Agent | - |
| FOUNTAIN MANOR HOLDINGS LLC | Manager | - |
| CHAVIN SAMUEL | Manager | 3300 LAUREL OAKS STREET, FORT LAUDERDALE, FL, 33312 |
| BURSTEIN JONATHAN | Manager | 5647 BROOKFIELD CIRCLE E, FORT LAUDERDALE, FL, 33312 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000086645 | FOUNTAIN MANOR HEALTH & REHABILITATION CENTER | EXPIRED | 2014-08-22 | 2024-12-31 | - | 390 NE 135TH STREET, MIAMI, FL, 33161 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2023-09-25 | - | - |
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-17 | 3458 LAKESHORE DRIVE, TALLAHASSEE, FL 32312 | - |
| LC AMENDMENT | 2018-08-17 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2015-04-03 | 390 NE 135th Street, Miami, FL 33161 | - |
| CHANGE OF MAILING ADDRESS | 2015-04-03 | 390 NE 135th Street, Miami, FL 33161 | - |
| REGISTERED AGENT NAME CHANGED | 2015-04-03 | INCORP SERVICES, INC. | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-24 |
| LC Amendment | 2023-09-25 |
| ANNUAL REPORT | 2023-04-26 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-04-25 |
| ANNUAL REPORT | 2020-03-26 |
| ANNUAL REPORT | 2019-03-18 |
| LC Amendment | 2018-08-17 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-03-31 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1087197110 | 2020-04-09 | 0455 | PPP | 390 NE 135th Street, MIAMI, FL, 33161-3967 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Apr 2025
Sources: Florida Department of State
