| Entity Name: | HEART OF GOLD SENIOR SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 16 Jan 2018 (7 years ago) |
| Document Number: | L18000014615 |
| FEI/EIN Number | 30-0868273 |
| Address: | 1915 Bartley St, Haines City, FL 33844 |
| Mail Address: | 1915 Bartley St, Haines City, FL 33844 |
| ZIP code: | 33844 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760966725 | 2018-09-17 | 2024-07-24 | 1915 BARTLEY ST, HAINES CITY, FL, 338442925, US | 1508 LAKE ALFRED RD, LAKE ALFRED, FL, 338503166, US | |||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||
| Phone | +1 863-595-8927 |
| Fax | 8638772974 |
Authorized person
| Name | MS. LISA ANN WADE |
| Role | ADMINISTRATOR/OWNER |
| Phone | 8635958927 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
| Taxonomy Code | 372600000X - Adult Companion |
| Is Primary | No |
| Taxonomy Code | 376J00000X - Homemaker |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 101313200 |
| State | FL |
| Name | Role |
|---|---|
| ACCOUNTING & TAX EDGE LLC | Agent |
| Name | Role | Address |
|---|---|---|
| WADE, LISA A | Manager | 1915 BARTLEY ST, HAINES CITY, FL 33844 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000001302 | HEART OF GOLD CPR | ACTIVE | 2023-01-04 | 2028-12-31 | No data | 1915 BARTLEY ST, HAINES CITY, FL, 33844 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-01-24 | 1915 Bartley St, Haines City, FL 33844 | No data |
| CHANGE OF MAILING ADDRESS | 2024-01-24 | 1915 Bartley St, Haines City, FL 33844 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J22000352254 | ACTIVE | 1000000928896 | POLK | 2022-07-18 | 2032-07-20 | $ 1,084.60 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, LAKELAND SERVICE CENTER, 115 S MISSOURI AVE STE 202, LAKELAND FL338154644 |
| J21000172050 | ACTIVE | 1000000884110 | POLK | 2021-04-08 | 2031-04-14 | $ 1,606.98 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, LAKELAND SERVICE CENTER, 115 S MISSOURI AVE STE 202, LAKELAND FL338154644 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-01-07 |
| ANNUAL REPORT | 2022-01-14 |
| ANNUAL REPORT | 2021-01-04 |
| ANNUAL REPORT | 2020-06-23 |
| ANNUAL REPORT | 2019-01-04 |
| Florida Limited Liability | 2018-01-16 |
Date of last update: 17 Feb 2025
Sources: Florida Department of State
