| Entity Name: | WILSONS CARING PLACE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 Feb 2017 (8 years ago) |
| Document Number: | L17000041793 |
| FEI/EIN Number | 81-5475837 |
| Address: | 5402 Golden Nugget Dr, Holiday, FL, 34690-6205, US |
| Mail Address: | 5402 Golden Nugget Dr, HOLIDAY, FL, 34690, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043831696 | 2020-05-05 | 2020-09-24 | PO BOX 864, PORT RICHEY, FL, 346730864, US | 5609 US HWY 19, STE G, NEW PORT RICHEY, FL, 346523754, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 727-851-3949 |
| Fax | 8666750558 |
Authorized person
| Name | TIFFANY WILSON |
| Role | EXECUTIVE DIRECTOR |
| Phone | 7278513949 |
Taxonomy
| Taxonomy Code | 251C00000X - Developmentally Disabled Services Day Training Agency |
| Is Primary | Yes |
| Taxonomy Code | 372600000X - Adult Companion |
| Is Primary | No |
| Taxonomy Code | 376J00000X - Homemaker |
| Is Primary | No |
| Taxonomy Code | 385HR2065X - Child Physical Disabilities Respite Care |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 022088500 |
| State | FL |
| Issuer | MEDICAID |
| Number | 236478 |
| State | FL |
| Name | Role |
|---|---|
| WILSONS CARING PLACE LLC | Agent |
| Name | Role | Address |
|---|---|---|
| Wilson Tiffany N | Manager | 5402 Golden Nugget Dr, Holiday, FL, 346906205 |
| Wilson Antonie | Manager | 5402 Golden Nugget Dr, Holiday, FL, 346906205 |
| Name | Role |
|---|---|
| WILSONS CARING PLACE LLC | Chief Executive Officer |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-12 | 5402 Golden Nugget Dr, Holiday, FL 34690-6205 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-12 | 5402 Golden Nugget Dr, Holiday, FL 34690-6205 | No data |
| CHANGE OF MAILING ADDRESS | 2021-02-19 | 5402 Golden Nugget Dr, Holiday, FL 34690-6205 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-01-15 | Wilsons Caring Place LLC. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-12 |
| ANNUAL REPORT | 2023-03-17 |
| ANNUAL REPORT | 2022-03-11 |
| ANNUAL REPORT | 2021-02-19 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-04-18 |
| ANNUAL REPORT | 2018-04-27 |
| Florida Limited Liability | 2017-02-22 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
