| Entity Name: | GUARDIAN HOME II ALF, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 23 Aug 2016 (8 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 26 Sep 2018 (6 years ago) |
| Document Number: | L16000158173 |
| FEI/EIN Number | 20-4962843 |
| Address: | 902 CANAL ST, NEW SMYRNA BEACH, FL, 32168, US |
| Mail Address: | 902 CANAL ST, NEW SMYRNA BEACH, FL, 32168, US |
| ZIP code: | 32168 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174707640 | 2007-12-19 | 2009-03-03 | 431 EAST AIRPORT BLVD., SANFORD, FL, 327735494, US | 902 CANAL ST., NEW SMYRNA BEACH, FL, 32168, US | |||||||||||||||||||||||||||||
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| Phone | +1 407-323-2545 |
| Fax | 4073232545 |
| Phone | +1 386-409-9455 |
| Fax | 3864099456 |
Authorized person
| Name | MRS. GLADYS FERNANDO |
| Role | ADMINISTRATOR |
| Phone | 3864099456 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL55 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 142656700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FERNANDO FERNANDO | Agent | 357 CONCH KEY WAY, SANFORD, FL, 32771 |
| Name | Role | Address |
|---|---|---|
| FERNANDO GLADYS | Authorized Member | 357 CONCH KEY WAY, SANFORD, FL, 32771 |
| FERNANDO FERNANDO | Authorized Member | 357 CONCH KEY WAY, SANFORD, FL, 32771 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2018-09-26 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-05-01 | 357 CONCH KEY WAY, SANFORD, FL 32771 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-08 |
| ANNUAL REPORT | 2023-04-18 |
| ANNUAL REPORT | 2022-02-02 |
| ANNUAL REPORT | 2021-04-28 |
| ANNUAL REPORT | 2020-04-28 |
| ANNUAL REPORT | 2019-04-30 |
| LC Amendment | 2018-09-26 |
| ANNUAL REPORT | 2018-05-01 |
| ANNUAL REPORT | 2017-04-28 |
| Florida Limited Liability | 2016-08-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
