| Entity Name: | PATH TO PROGRESSIVE HEALTH CARE L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 06 Jul 2017 (8 years ago) |
| Document Number: | L17000145344 |
| FEI/EIN Number | 82-1638655 |
| Address: | 5999 Kalogridis road, Haines City, FL 33844 |
| Mail Address: | P.O Box 3247, Haines City, FL 33845 |
| ZIP code: | 33844 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356867717 | 2017-08-17 | 2022-07-21 | PO BOX 700584, SAINT CLOUD, FL, 347700584, US | 4174 CORSAIR AVE, KISSIMMEE, FL, 347412949, US | |||||||||||||||||||||
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| Phone | +1 321-805-2802 |
| Phone | +1 321-805-0282 |
Authorized person
| Name | LEWDY ENID MATIAS |
| Role | PRESIDENT |
| Phone | 3218050282 |
Taxonomy
| Taxonomy Code | 261QD1600X - Developmental Disabilities Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 13568687717 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MATIAS, LEWDY E | Agent | 5999 Kalogridis road, Haines City, FL 33844 |
| Name | Role | Address |
|---|---|---|
| Matias, Lewdy Enid | Manager | 5999 Kalogridis road, Haines City, FL 33844 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-07-26 | 5999 Kalogridis road, Haines City, FL 33844 | No data |
| CHANGE OF MAILING ADDRESS | 2022-07-26 | 5999 Kalogridis road, Haines City, FL 33844 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-04-29 | 5999 Kalogridis road, Haines City, FL 33844 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-03 |
| ANNUAL REPORT | 2024-02-18 |
| ANNUAL REPORT | 2023-03-17 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-02-23 |
| ANNUAL REPORT | 2020-02-17 |
| ANNUAL REPORT | 2019-02-28 |
| AMENDED ANNUAL REPORT | 2018-03-30 |
| ANNUAL REPORT | 2018-03-01 |
| Florida Limited Liability | 2017-07-06 |
Date of last update: 18 Feb 2025
Sources: Florida Department of State
