| Entity Name: | FLEMING SUPPORT SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 05 Jul 2016 (9 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 24 Jul 2024 (7 months ago) |
| Document Number: | L16000126878 |
| FEI/EIN Number | 81-3275232 |
| Address: | 2304 BURPEE DRIVE WEST, JACKSONVILLE, FL, 32210 |
| Mail Address: | 2304 BURPEE DRIVE WEST, JACKSONVILLE, FL, 32210 |
| ZIP code: | 32210 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912643719 | 2022-05-05 | 2024-10-10 | 2304 BURPEE DR W, JACKSONVILLE, FL, 322103739, US | 2304 BURPEE DR W, JACKSONVILLE, FL, 322103739, US | |||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||
| Phone | +1 904-414-1211 |
| Fax | 8669520945 |
Authorized person
| Name | TAHNITA FLEMING |
| Role | OWNER |
| Phone | 9044141211 |
Taxonomy
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| Is Primary | No |
| Taxonomy Code | 343900000X - Non-emergency Medical Transport (VAN) |
| Is Primary | No |
| Taxonomy Code | 347C00000X - Private Vehicle |
| Is Primary | No |
| Taxonomy Code | 3747A0650X - Attendant Care Provider |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 024592000 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FLEMING SUPPORT SERVICES 401(K) PLAN | 2023 | 813275232 | 2024-05-07 | FLEMING SUPPORT SERVICES | 3 | |||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||
| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2024-05-07 |
| Name of individual signing | QIAN LIU |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-01-01 |
| Business code | 812190 |
| Sponsor’s telephone number | 9044141211 |
| Plan sponsor’s address | 7643 GATE PARKWAY, SUITE 104-516, JACKSONVILLE, FL, 32256 |
Plan administrator’s name and address
| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2023-05-30 |
| Name of individual signing | CHRISTINE RIMER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| FLEMING TAHNITA D | Agent | 2304 BURPEE DRIVE WEST, JACKSONVILLE, FL, 32210 |
| Name | Role | Address |
|---|---|---|
| FLEMING TAHNITA | Manager | 2304 BURPEE DRIVE WEST, JACKSONVILLE, FL, 32210 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2024-07-24 | No data | No data |
| LC AMENDMENT | 2016-09-08 | No data | No data |
| Name | Date |
|---|---|
| LC Amendment | 2024-07-24 |
| ANNUAL REPORT | 2024-03-22 |
| ANNUAL REPORT | 2023-04-11 |
| ANNUAL REPORT | 2022-02-18 |
| ANNUAL REPORT | 2021-01-30 |
| ANNUAL REPORT | 2020-06-01 |
| ANNUAL REPORT | 2019-01-11 |
| ANNUAL REPORT | 2018-04-13 |
| ANNUAL REPORT | 2017-03-29 |
| LC Amendment | 2016-09-08 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
