| Entity Name: | S&S SENIOR HOUSING OF MADISON, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 28 Oct 2016 (8 years ago) |
| Document Number: | L16000199349 |
| FEI/EIN Number | 81-4435198 |
| Mail Address: | 302 WI PARKWAY, DALLAS, GA, 30132 |
| Address: | 765 NE DELPHINIUM DRIVE, MADISON, FL, 32340 |
| ZIP code: | 32340 |
| County: | Madison |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962937359 | 2017-04-24 | 2017-04-24 | 765 NE DELPHINIUM DR, MADISON, FL, 323405412, US | 765 NE DELPHINIUM DR, MADISON, FL, 323405412, US | |||||||||||||||||
|
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| Phone | +1 850-973-6892 |
Authorized person
| Name | MARK SIMONS |
| Role | OWNER |
| Phone | 8509736892 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | 6020 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SIMONS MARK | Agent | 765 NE DELPHINIUM DRIVE, MADISON, FL, 30340 |
| Name | Role | Address |
|---|---|---|
| SIMONS MARK | Manager | 302 WI PARKWAY, DALLAS, GA, 30132 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000091561 | SOUTHERN LIVING FOR SENIORS | ACTIVE | 2020-07-29 | 2025-12-31 | No data | 765 NE DELPHENIUM DRIVE, MADISON, FL, 32340 |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J24000445237 | ACTIVE | 1000000995747 | MADISON | 2024-07-11 | 2034-07-17 | $ 6,176.95 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, LAKE CITY SERVICE CENTER, 1415 W US HIGHWAY 90 STE 115, LAKE CITY FL320556156 |
| J24000453058 | ACTIVE | 1000001002402 | MADISON | 2024-07-11 | 2034-07-17 | $ 2,409.18 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, LAKE CITY SERVICE CENTER, 1415 W US HIGHWAY 90 STE 115, LAKE CITY FL320556156 |
| J24000046357 | ACTIVE | 19-383-1A-OPA | LEON COUNTY | 2023-11-13 | 2029-01-24 | $18,012.10 | DFS DIVISION OF WORKERS COMPENSATION, 200 EAST GAINES STREET, TALLAHASSEE, FL 32399-4228 |
| J24000355741 | ACTIVE | 1000000947060 | MADISON | 2023-04-10 | 2034-06-12 | $ 1,669.37 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, LAKE CITY SERVICE CENTER, 1415 W US HIGHWAY 90 STE 115, LAKE CITY FL320556156 |
| J21000204309 | TERMINATED | 1000000886428 | MADISON | 2021-04-23 | 2031-04-28 | $ 7,049.41 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE COLLECTIONS UNIT, 1415 W US HIGHWAY 90 STE 115, LAKE CITY FL320556156 |
| J19000471191 | TERMINATED | 1000000832030 | MADISON | 2019-07-02 | 2029-07-10 | $ 1,470.65 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE COLLECTIONS UNIT, 1415 W US HIGHWAY 90 STE 115, LAKE CITY FL320556156 |
| J19000192813 | TERMINATED | 1000000818362 | MADISON | 2019-03-05 | 2029-03-13 | $ 457.67 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE COLLECTIONS UNIT, 1415 W US HIGHWAY 90 STE 115, LAKE CITY FL320556156 |
| J19000075281 | TERMINATED | 1000000812469 | MADISON | 2019-01-22 | 2029-01-30 | $ 1,697.85 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE COLLECTIONS UNIT, 1415 W US HIGHWAY 90 STE 115, LAKE CITY FL320556156 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-02 |
| ANNUAL REPORT | 2023-04-01 |
| ANNUAL REPORT | 2022-03-29 |
| ANNUAL REPORT | 2021-04-10 |
| ANNUAL REPORT | 2020-05-15 |
| ANNUAL REPORT | 2019-03-30 |
| ANNUAL REPORT | 2018-03-30 |
| ANNUAL REPORT | 2017-03-30 |
| Florida Limited Liability | 2016-10-28 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
