| Entity Name: | GENESIS HOME CARE AND MENTAL HEALTH SERVICES L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 26 Sep 2017 (7 years ago) |
| Date of dissolution: | 27 Sep 2024 (4 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (4 months ago) |
| Document Number: | L17000198878 |
| FEI/EIN Number | 82-2938561 |
| Address: | 8750 Humberside Ln, JACKSONVILLE, FL, 32219, US |
| Mail Address: | PO BOX 47164, JACKSONVILLE, FL, 32247 |
| ZIP code: | 32219 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043829682 | 2020-07-29 | 2020-07-29 | PO BOX 47164, JACKSONVILLE, FL, 322477164, US | 8750 HUMBERSIDE LN, JACKSONVILLE, FL, 322194317, US | |||||||||||||||||||||||||||
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| Phone | +1 904-713-1993 |
Authorized person
| Name | MR. STEVEN BYRD |
| Role | OWNER |
| Phone | 9047131993 |
Taxonomy
| Taxonomy Code | 251C00000X - Developmentally Disabled Services Day Training Agency |
| Is Primary | Yes |
| Taxonomy Code | 372600000X - Adult Companion |
| Is Primary | No |
| Taxonomy Code | 385H00000X - Respite Care |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 102625400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BYRD STEVEN | Agent | 8750 HUMBERSIDE LN, JACKSONVILLE, FL, 32219 |
| Name | Role | Address |
|---|---|---|
| Nicholas De'Anna | Manager | 8750 Humberside Lane, Jacksonville, FL, 32219 |
| Name | Role | Address |
|---|---|---|
| Byrd Steven | Managing Member | PO BOX 47164, JACKSONVILLE, FL, 32247 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| REINSTATEMENT | 2020-04-14 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-04-14 | 8750 Humberside Ln, JACKSONVILLE, FL 32219 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-04-14 | BYRD, STEVEN | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2023-04-30 |
| ANNUAL REPORT | 2022-06-10 |
| ANNUAL REPORT | 2021-04-29 |
| AMENDED ANNUAL REPORT | 2020-04-15 |
| REINSTATEMENT | 2020-04-14 |
| Florida Limited Liability | 2017-09-26 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
