Entity Name: | GLENVILLE PINES II ASSISTED LIVING FACILITY LLC |
Jurisdiction: | FLORIDA |
Filing Type: | Florida Limited Liability Company |
Status: | Inactive |
Date Filed: | 18 Jul 2017 (8 years ago) |
Date of dissolution: | 10 Mar 2022 (3 years ago) |
Last Event: | VOLUNTARY DISSOLUTION |
Event Date Filed: | 10 Mar 2022 (3 years ago) |
Document Number: | L17000153962 |
FEI/EIN Number | 82-2318756 |
Mail Address: | 1351 STEELE RD S.E., PALM BAY, FL 32909 |
Address: | 211 SILVER OA RD NE, PALM BAY, FL 32907 |
ZIP code: | 32907 |
County: | Brevard |
Place of Formation: | FLORIDA |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1447756655 | 2018-04-05 | 2018-04-05 | 1351 STEELE RD SE, PALM BAY, FL, 329095332, US | 211 SILVER OAK RD NE, PALM BAY, FL, 329075582, US | |||||||||||||||||||||||||||
|
Phone | +1 321-258-4056 |
Phone | +1 321-802-4121 |
Fax | 3219847568 |
Authorized person
Name | MS. ELIDA M REYES-KERR |
Role | ADMINISTRATOR |
Phone | 3212584056 |
Taxonomy
Taxonomy Code | 310400000X - Assisted Living Facility |
License Number | AL12461 |
State | FL |
Is Primary | Yes |
Other Provider Identifiers
Issuer | MEDICAID |
Number | 022322700 |
State | FL |
Name | Role | Address |
---|---|---|
HILL ACCOUNTING & TAX SERVICE | Agent | 314 LAURIE STREET, MELBOURNE, FL 32935 |
Name | Role | Address |
---|---|---|
REYES-KERR, ELIDA | Manager | 1351 STEELE RD S.E., PALM BAY, FL 32909 |
KERR, GLENFORD | Manager | 1701 HAYS ST, PALM BAY, FL 32909 |
Event Type | Filed Date | Value | Description |
---|---|---|---|
VOLUNTARY DISSOLUTION | 2022-03-10 | No data | No data |
REINSTATEMENT | 2018-10-10 | No data | No data |
CHANGE OF PRINCIPAL ADDRESS | 2018-10-10 | 211 SILVER OA RD NE, PALM BAY, FL 32907 | No data |
REGISTERED AGENT NAME CHANGED | 2018-10-10 | HILL ACCOUNTING & TAX SERVICE | No data |
ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
Name | Date |
---|---|
VOLUNTARY DISSOLUTION | 2022-03-10 |
ANNUAL REPORT | 2021-04-30 |
ANNUAL REPORT | 2020-06-30 |
ANNUAL REPORT | 2019-06-13 |
REINSTATEMENT | 2018-10-10 |
Florida Limited Liability | 2017-07-18 |
Date of last update: 18 Feb 2025
Sources: Florida Department of State