| Entity Name: | J&T DIVINE CARE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 20 May 2015 (10 years ago) |
| Last Event: | LC DISSOCIATION MEM |
| Event Date Filed: | 23 Jul 2020 (5 years ago) |
| Document Number: | L15000089121 |
| FEI/EIN Number | 47-4083114 |
| Address: | 440 ROLLEYOU LANE, MOUNT DORA, FL, 32757, US |
| Mail Address: | 440 ROLLEYOU LANE, MOUNT DORA, FL, 32757, US |
| ZIP code: | 32757 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043966476 | 2022-02-24 | 2022-03-20 | 440 ROYELLOU LN STE 205, MOUNT DORA, FL, 327575520, US | 440 ROYELLOU LN STE 205, MOUNT DORA, FL, 327575520, US | |||||||||||||||||||||||||
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| Phone | +1 407-756-9492 |
| Fax | 3527292210 |
Authorized person
| Name | TESICA BARNES |
| Role | ADMINISTRATOR |
| Phone | 4077569982 |
Taxonomy
| Taxonomy Code | 251J00000X - Nursing Care Agency |
| Is Primary | No |
| Taxonomy Code | 3747A0650X - Attendant Care Provider |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 109695900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BARNES TESICA L | Agent | 29917 Cypress Pointe, TAVARES, FL, 32778 |
| Name | Role | Address |
|---|---|---|
| BARNES TESICA L | Manager | 29917 Cypress Pointe, TAVARES, FL, 32778 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-17 | 29917 Cypress Pointe, TAVARES, FL 32778 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-10-26 | 440 ROLLEYOU LANE, SUITE 205, MOUNT DORA, FL 32757 | No data |
| CHANGE OF MAILING ADDRESS | 2021-10-26 | 440 ROLLEYOU LANE, SUITE 205, MOUNT DORA, FL 32757 | No data |
| LC DISSOCIATION MEM | 2020-07-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-17 |
| ANNUAL REPORT | 2023-03-30 |
| ANNUAL REPORT | 2022-05-06 |
| ANNUAL REPORT | 2021-03-31 |
| CORLCDSMEM | 2020-07-23 |
| ANNUAL REPORT | 2020-06-07 |
| ANNUAL REPORT | 2019-03-30 |
| ANNUAL REPORT | 2018-03-25 |
| ANNUAL REPORT | 2017-04-22 |
| ANNUAL REPORT | 2016-03-08 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
