| Entity Name: | EVERLASTING FAMILY HOME CARE SERVICES "LLC" |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 26 Mar 2015 (10 years ago) |
| Document Number: | L15000053850 |
| FEI/EIN Number | 47-3528593 |
| Address: | 2722 OKLAHOMA STREET, WEST PALM BEACH, FL, 33406 |
| Mail Address: | 2722 OKLAHOMA STREET, WEST PALM BEACH, FL, 33406 |
| ZIP code: | 33406 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346607959 | 2016-01-27 | 2016-08-26 | 2722 OKLAHOMA ST, WEST PALM BEACH, FL, 334064212, US | 2722 OKLAHOMA ST, WEST PALM BEACH, FL, 334064212, US | |||||||||||||||||||||||||
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| Phone | +1 561-907-6956 |
| Fax | 5615139365 |
Authorized person
| Name | MR. DUVENSON JEAN DENIS |
| Role | PROVIDER |
| Phone | 5619076056 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | 12890 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 016168600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| JEAN DENIS DUVENSON | Agent | 2722 OKLAHOMA STREET, WEST PALM BEACH, FL, 33406 |
| Name | Role | Address |
|---|---|---|
| JEAN DENIS CELIANNE | Owner | 2722 OKLAHOMA STREET, WEST PALM BEACH, FL, 33406 |
| Name | Role | Address |
|---|---|---|
| JEAN DENIS DUVENSON | Manager | 2722 OKLAHOMA STREET, WEST PALM BEACH, FL, 33406 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000099059 | PALM BEACH COUNTY ASSISTED LIVING FACILITY | EXPIRED | 2016-09-09 | 2021-12-31 | No data | 2722 OKLAHOMA STREET, WEST PALM BEACH, FL, 33406 |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J18000599852 | TERMINATED | 1000000793046 | PALM BEACH | 2018-08-08 | 2028-08-29 | $ 957.47 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, WEST PALM BEACH SERVICE CENTER, 2468 METROCENTRE BLVD, WEST PALM BEACH FL334073105 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-02 |
| ANNUAL REPORT | 2023-04-08 |
| ANNUAL REPORT | 2022-04-18 |
| ANNUAL REPORT | 2021-03-29 |
| ANNUAL REPORT | 2020-05-31 |
| ANNUAL REPORT | 2019-05-07 |
| ANNUAL REPORT | 2018-04-07 |
| ANNUAL REPORT | 2017-02-28 |
| ANNUAL REPORT | 2016-02-19 |
| Florida Limited Liability | 2015-03-26 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
