| Entity Name: | ADVANCED CARE HEALTH SOLUTIONS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 11 Jul 2017 (8 years ago) |
| Document Number: | L17000148752 |
| FEI/EIN Number | 82-2130815 |
| Address: | 4856 Monroe Forest Dr., Jacksonville, FL, 32257, US |
| Mail Address: | 4856 Monroe Forest Dr., Jacksonville, FL, 32257, US |
| ZIP code: | 32257 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568978617 | 2017-12-26 | 2018-06-16 | 9225 PROSPERITY LAKE DR, JACKSONVILLE, FL, 322448446, US | 9225 PROSPERITY LAKE DR, JACKSONVILLE, FL, 322448446, US | |||||||||||||||||||
|
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| Phone | +1 252-813-2409 |
Authorized person
| Name | YOLANDA BASCOME |
| Role | OWNER |
| Phone | 2528132409 |
Taxonomy
| Taxonomy Code | 261QD1600X - Developmental Disabilities Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 640473 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BASCOME YOLANDA | Agent | 4856 Monroe Forest Dr., Jacksonville, FL, 32257 |
| Name | Role | Address |
|---|---|---|
| Bascome Yolanda | Owne | 4856 Monroe Forest Dr., Jacksonville, FL, 32257 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-21 | 4856 Monroe Forest Dr., Jacksonville, FL 32257 | No data |
| CHANGE OF MAILING ADDRESS | 2022-04-21 | 4856 Monroe Forest Dr., Jacksonville, FL 32257 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-04-21 | 4856 Monroe Forest Dr., Jacksonville, FL 32257 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-18 |
| ANNUAL REPORT | 2023-04-15 |
| ANNUAL REPORT | 2022-04-21 |
| ANNUAL REPORT | 2021-04-28 |
| ANNUAL REPORT | 2020-04-28 |
| ANNUAL REPORT | 2019-04-23 |
| ANNUAL REPORT | 2018-03-09 |
| Florida Limited Liability | 2017-07-11 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
