| Entity Name: | INTEGRITY - HUDSON MANOR, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 19 Jan 2016 (9 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 28 Feb 2018 (7 years ago) |
| Document Number: | L16000012856 |
| FEI/EIN Number | 38-3995736 |
| Mail Address: | 4900 Koger Blvd, Suite 150, Greensboro, NC 27407 |
| Address: | 1515 Indian River Blvd, Suite A245, Vero Beach, FL 32960 |
| ZIP code: | 32960 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518400811 | 2016-11-18 | 2021-11-18 | 4900 KOGER BLVD STE 150, GREENSBORO, NC, 274072738, US | 13009 LAKE KARL DR, HUDSON, FL, 346692374, US | |||||||||||||||||||||||||
|
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| Phone | +1 336-438-1383 |
| Fax | 3364381387 |
| Phone | +1 727-856-5282 |
| Fax | 7278567163 |
Authorized person
| Name | JONATHAN S SHORT |
| Role | CIO |
| Phone | 3364381383 |
Taxonomy
| Taxonomy Code | 3104A0625X - Assisted Living Facility (Mental Illness) |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 0245489 |
| State | FL |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| Short, Jonathan Swain | Chief Information Officer | 4900 Koger Blvd, Suite 150 Greensboro, NC 27407 |
| Name | Role | Address |
|---|---|---|
| Leonard, Frederic H | Chief Executive Officer | 4900 Koger Blvd, Suite 150 Greensboro, NC 27407 |
| Name | Role | Address |
|---|---|---|
| Wright, Don | Chairman | 1515 Indian River Blvd, Suite A245 Vero Beach, FL 32960 |
| Name | Role | Address |
|---|---|---|
| INTEGRITY SENIOR PROPERTIES INVESTMENT LLC | Authorized Member | 1515 Indian River Blvd, Suite A245 Vero Beach, FL 32960 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000061184 | HUDSON MANOR ASSISTED LIVING | ACTIVE | 2016-06-21 | 2026-12-31 | No data | 13009 LAKE KARL DRIVE, HUDSON, FL, 34669 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-02-02 | 1515 Indian River Blvd, Suite A245, Vero Beach, FL 32960 | No data |
| CHANGE OF MAILING ADDRESS | 2022-02-02 | 1515 Indian River Blvd, Suite A245, Vero Beach, FL 32960 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-02-19 | C T CORPORATION SYSTEM | No data |
| LC STMNT OF RA/RO CHG | 2018-02-28 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-02-28 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-21 |
| ANNUAL REPORT | 2023-02-23 |
| ANNUAL REPORT | 2022-02-02 |
| ANNUAL REPORT | 2021-02-19 |
| ANNUAL REPORT | 2020-01-25 |
| ANNUAL REPORT | 2019-01-14 |
| CORLCRACHG | 2018-02-28 |
| ANNUAL REPORT | 2018-01-09 |
| ANNUAL REPORT | 2017-06-22 |
| Florida Limited Liability | 2016-01-19 |
Date of last update: 20 Jan 2025
Sources: Florida Department of State
