| Entity Name: | ASSURANCE COMFORT LIVING LLC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 18 Apr 2016 (9 years ago) |
| Document Number: | L16000075702 |
| FEI/EIN Number | APPLIED FOR |
| Address: | 11052 CAPTAIN DR, SPRING HILL, FL 34608 |
| Mail Address: | 11052 CAPTAIN DR, SPRING HILL, FL 34608 |
| ZIP code: | 34608 |
| County: | Hernando |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1699233197 | 2019-03-04 | 2024-09-10 | 11052 CAPTAIN DR, SPRING HILL FL 34608, SPRING HILL, FL, 346085008, US | 11052 CAPTAIN DR, SPRING HILL FL 34608, SPRING HILL, FL, 346085008, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 813-416-4685 |
Authorized person
| Name | MARIE MICHELLE ROBINSON |
| Role | OWNER |
| Phone | 8134164685 |
Taxonomy
| Taxonomy Code | 163W00000X - Registered Nurse |
| Is Primary | No |
| Taxonomy Code | 163WH0200X - Home Health Registered Nurse |
| Is Primary | No |
| Taxonomy Code | 163WI0500X - Infusion Therapy Registered Nurse |
| Is Primary | No |
| Taxonomy Code | 163WW0000X - Wound Care Registered Nurse |
| Is Primary | No |
| Taxonomy Code | 163WX1500X - Ostomy Care Registered Nurse |
| Is Primary | No |
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
| Taxonomy Code | 251J00000X - Nursing Care Agency |
| Is Primary | No |
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| Is Primary | No |
| Taxonomy Code | 385HR2060X - Child Intellectual and/or Developmental Disabilities Respite Care |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 021961100 |
| State | FL |
| Issuer | MEDICAID |
| Number | 017251700 |
| State | FL |
| Issuer | MEDICAID |
| Number | 021958600 |
| State | FL |
| Issuer | MEDICAID |
| Number | 017251701 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ASSURANCE COMFORT LIVING 401K PLAN | 2022 | 812322446 | 2023-10-06 | ASSURANCE COMFORT LIVING LLC | 6 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2023-10-06 |
| Name of individual signing | THOMAS MILLER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| FOCUS 9 ENTERPRISES LLC | Agent |
| Name | Role | Address |
|---|---|---|
| ROBINSON, MARIE M | PRESIDENT | 11052 CAPTAIN DR, SPRING HILL, FL 34608 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000035708 | ACL DIVINE QUALITY HEALTH AGENCY | ACTIVE | 2023-03-17 | 2028-12-31 | No data | 11052 CAPTAIN DR, SPRING HILL, FL, 34608 |
| G23000018058 | A SUPERIOR QUALITY CARE | ACTIVE | 2023-02-07 | 2028-12-31 | No data | 11052 CAPTAIN DRIVE, SPRING HILL, FL, 34608 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2022-04-12 | FOCUS 9 ENTERPRISES LLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-04-12 | 2728 ENTERPRISE RD, STE 200, ORANGE CITY, FL 32763 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-29 | 11052 CAPTAIN DR, SPRING HILL, FL 34608 | No data |
| CHANGE OF MAILING ADDRESS | 2021-04-29 | 11052 CAPTAIN DR, SPRING HILL, FL 34608 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-25 |
| ANNUAL REPORT | 2023-03-22 |
| ANNUAL REPORT | 2022-04-12 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-03-27 |
| ANNUAL REPORT | 2019-04-04 |
| ANNUAL REPORT | 2018-03-18 |
| ANNUAL REPORT | 2017-04-25 |
| Florida Limited Liability | 2016-04-18 |
Date of last update: 20 Jan 2025
Sources: Florida Department of State
