| Entity Name: | BLUE HERON HEALTH AND REHABILITATION LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 27 Jun 2017 (8 years ago) |
| Last Event: | LC STMNT OF AUTHORITY 21 |
| Event Date Filed: | 08 Apr 2019 (6 years ago) |
| Document Number: | L17000139756 |
| FEI/EIN Number | 82-2015151 |
| Address: | 1800 N WABASH RD, MARION, IN, 46952, US |
| Mail Address: | 1800 N WABASH RD, MARION, IN, 46952, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972193712 | 2021-01-26 | 2021-04-06 | 1800 N WABASH RD, MARION, IN, 469521300, US | 5085 EAGLESTON BOULEVARD, WESLEY CHAPEL, FL, 33544, US | |||||||||||||||||
|
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| Phone | +1 765-664-5400 |
| Fax | 7656645403 |
| Phone | +1 813-454-0513 |
Authorized person
| Name | BETH R KLEE |
| Role | EXECUTIVE ASSISTANT |
| Phone | 7656645400 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Lanham Steve | Agent | 27177 Cooper Creek Court, Wesley Chapel, FL, 33544 |
| Name | Role | Address |
|---|---|---|
| OTT GARY L | Member | 4158 Skyway Dr, Naples, FL, 34112 |
| Name | Role | Address |
|---|---|---|
| OTT DWIGHT A | Authorized Member | 2214 MEADOWBROOK DRIVE, MARION, IN, 46952 |
| OTT RYAN M | Authorized Member | 4158 N Huntington Rd, Marion, IN, 46952 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000101975 | BLUE HERON ASSISTED LIVING | ACTIVE | 2020-08-11 | 2025-12-31 | No data | 1800 N WABASH RD, MARION, IN, 46952 |
| G20000101980 | BLUE HERON SENIOR LIVING | ACTIVE | 2020-08-11 | 2025-12-31 | No data | 1800 N WABASH RD, MARION, IN, 46952 |
| G20000101988 | BLUE HERON HEALTH AND REHABILITATION CENTER | ACTIVE | 2020-08-11 | 2025-12-31 | No data | 1800 N WABASH RD, MARION, IN, 46952 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC STMNT OF AUTHORITY | 2019-04-08 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2019-02-27 | Lanham, Steve | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-02-27 | 27177 Cooper Creek Court, Wesley Chapel, FL 33544 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-10 |
| ANNUAL REPORT | 2023-02-17 |
| ANNUAL REPORT | 2022-02-23 |
| ANNUAL REPORT | 2021-02-15 |
| ANNUAL REPORT | 2020-01-16 |
| CORLCAUTH | 2019-04-08 |
| ANNUAL REPORT | 2019-02-27 |
| ANNUAL REPORT | 2018-03-06 |
| Florida Limited Liability | 2017-06-27 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
