| Entity Name: | LIGHTHOUSE HEALTH PLAN, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
LIGHTHOUSE HEALTH PLAN, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 18 Oct 2017 (8 years ago) |
| Date of dissolution: | 21 Jun 2023 (2 years ago) |
| Last Event: | LC VOLUNTARY DISSOLUTION |
| Event Date Filed: | 21 Jun 2023 (2 years ago) |
| Document Number: | L17000216087 |
| FEI/EIN Number |
82-3182832
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1717 North E Street, Suite 320, Pensacola, FL, 32501, US |
| Mail Address: | 1717 North E Street, Suite 320, Pensacola, FL, 32501, US |
| ZIP code: | 32501 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285109587 | 2018-10-12 | 2018-10-12 | 700 E GREGORY ST, PENSACOLA, FL, 325024142, US | 700 E GREGORY ST, PENSACOLA, FL, 325024142, US | |||||||||||||||||||||||||
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| Phone | +1 850-908-3001 |
Authorized person
| Name | SCOTT METHENY |
| Role | CFO |
| Phone | 8509083001 |
Taxonomy
| Taxonomy Code | 302R00000X - Health Maintenance Organization |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1001225-02 |
| State | FL |
| Issuer | MEDICAID |
| Number | 1001225-01 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| EVOLENT HEALTH LLC | Manager | - |
| Gleason Michael | Chief Executive Officer | 1717 North E Street, Pensacola, FL, 32501 |
| CALLAHAN ELIZABETH C | Agent | 1717 NORTH E STREET, PENSACOLA, FL, 32501 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC VOLUNTARY DISSOLUTION | 2023-06-21 | - | - |
| CHANGE OF MAILING ADDRESS | 2022-03-25 | 1717 North E Street, Suite 320, Pensacola, FL 32501 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2021-03-16 | 1717 North E Street, Suite 320, Pensacola, FL 32501 | - |
| LC AMENDMENT | 2017-11-01 | - | - |
| Name | Date |
|---|---|
| LC Voluntary Dissolution | 2023-06-21 |
| ANNUAL REPORT | 2022-03-25 |
| ANNUAL REPORT | 2021-03-16 |
| ANNUAL REPORT | 2020-06-10 |
| ANNUAL REPORT | 2019-01-16 |
| ANNUAL REPORT | 2018-03-12 |
| LC Amendment | 2017-11-01 |
| Florida Limited Liability | 2017-10-18 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
