| Entity Name: | SHALOM ALF HOME, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 18 Jan 2017 (8 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | L17000014661 |
| FEI/EIN Number | 815078382 |
| Address: | 2570 NE 215 STREE, AVENTURA, FL, 33180, US |
| Mail Address: | 2570 NE 215 STREE, AVENTURA, FL, 33180, US |
| ZIP code: | 33180 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982185708 | 2018-08-29 | 2018-08-29 | 2570 NE 215TH ST, MIAMI, FL, 331801056, US | 2570 NE 215TH ST, MIAMI, FL, 331801056, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 786-356-7211 |
Authorized person
| Name | JASON DAVIS |
| Role | OWNER |
| Phone | 7863567211 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | 13157 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Davis Jason M | Agent | 1900 Alamanda Dr, NORTH MIAMI, FL, 33181 |
| Name | Role | Address |
|---|---|---|
| DAVIS JASON M | Manager | 1900 ALAMANDA DR, NORTH MIAMI, FL, 33181 |
| Sade Rachel | Manager | 2570 NE 215 STREE, AVENTURA, FL, 33180 |
| Name | Role | Address |
|---|---|---|
| Romero Betty | Auth | 13005 ARCH CREEK TERRA, North Miami, FL, 33181 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2018-01-08 | Davis , Jason M | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-01-08 | 1900 Alamanda Dr, NORTH MIAMI, FL 33181 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-03-23 |
| ANNUAL REPORT | 2020-05-13 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-01-08 |
| Florida Limited Liability | 2017-01-18 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
