| Entity Name: | BLOSSOMS ASSISTED LIVING 1, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 14 Nov 2014 (10 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | L14000177470 |
| FEI/EIN Number | 47-2411452 |
| Address: | 1312 Mardrake Road, Daytona Beach, FL 32114 |
| Mail Address: | 40 Nicholas Court, Ormond Beach, FL 32176 |
| ZIP code: | 32114 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588051528 | 2015-04-16 | 2015-04-16 | 1312 MARDRAKE RD, DAYTONA BEACH, FL, 321145940, US | 1799 SERENO DR, DAVENPORT, FL, 338968603, US | |||||||||||||||||||||
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| Phone | +1 386-257-2162 |
| Fax | 3862572162 |
| Phone | +1 863-420-1463 |
Authorized person
| Name | MR. PAUL STURDGESS HAYES |
| Role | ADMINISTRATOR |
| Phone | 3862572162 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | 10287 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Riquer, Martha Lucia | Agent | 40 Nicholas Court, Ormond Beach, FL 32176 |
| Name | Role | Address |
|---|---|---|
| Riquer, Martha Lucia, Martha Lucia | Authorized Member | 40 Nicholas Court, Ormond Beach, FL 32176 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-11-09 | 1312 Mardrake Road, Daytona Beach, FL 32114 | No data |
| CHANGE OF MAILING ADDRESS | 2021-11-09 | 1312 Mardrake Road, Daytona Beach, FL 32114 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-11-09 | Riquer, Martha Lucia | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-11-09 | 40 Nicholas Court, Ormond Beach, FL 32176 | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2021-11-09 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-05-01 |
| ANNUAL REPORT | 2019-02-13 |
| ANNUAL REPORT | 2018-02-15 |
| ANNUAL REPORT | 2017-04-11 |
| ANNUAL REPORT | 2016-02-03 |
| ANNUAL REPORT | 2015-03-27 |
| Florida Limited Liability | 2014-11-14 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2159047410 | 2020-05-05 | 0491 | PPP | 1312 MARDRAKE ROAD, DAYTONA BEACH, FL, 32114 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 20 Feb 2025
Sources: Florida Department of State
