| Entity Name: | EMILIA'S DIRECT CARE AGENCY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 13 Mar 2017 (8 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | L17000056792 |
| FEI/EIN Number | 82-0767645 |
| Address: | 3218 E Colonial Dr, ORLANDO, FL, 32803, US |
| Mail Address: | 3218 E Colonial Dr, ORLANDO, FL, 32803, US |
| ZIP code: | 32803 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710404249 | 2017-08-25 | 2022-07-21 | 3218 E COLONIAL DR RM 118, ORLANDO, FL, 328035179, US | 3218 E COLONIAL DR RM 118, ORLANDO, FL, 32803, US | |||||||||||||||||||||||||||||
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| Phone | +1 407-779-6708 |
| Fax | 4076052753 |
Authorized person
| Name | JULIE TIBAUD |
| Role | OWNER |
| Phone | 4077796708 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 261QD1600X - Developmental Disabilities Clinic/Center |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 020485500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| TIBAUD JULIE | Agent | 3700 CURRY FORD ROAD, ORLANDO, FL, 32806 |
| Name | Role | Address |
|---|---|---|
| TIBAUD JULIE | Manager | 3700 CURRY FORD ROAD APT B8, ORLANDO, FL, 32806 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-03-01 | 3218 E Colonial Dr, Rm 118, ORLANDO, FL 32803 | No data |
| CHANGE OF MAILING ADDRESS | 2018-03-01 | 3218 E Colonial Dr, Rm 118, ORLANDO, FL 32803 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-03-01 |
| Florida Limited Liability | 2017-03-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
