| Entity Name: | EMPOWERED COMMUNITY LIVING, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 Feb 2018 (7 years ago) |
| Document Number: | L18000047578 |
| FEI/EIN Number | 82-5079082 |
| Address: | 1501 Robert J. Conlan Blvd NE, Palm Bay, FL, 32905, US |
| Mail Address: | 1501 Robert J. Conlan Blvd NE, Palm Bay, FL, 32905, US |
| ZIP code: | 32905 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1326516709 | 2018-11-05 | 2021-09-16 | 1501 ROBERT J CONLAN BLVD NE STE 110, PALM BAY, FL, 329053560, US | 1501 ROBERT J CONLAN BLVD NE STE 110, PALM BAY, FL, 329053560, US | |||||||||||||||||||||||||
|
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| Phone | +1 321-499-3265 |
Authorized person
| Name | TIMIKA MARIE WASHINGTON |
| Role | OWNER |
| Phone | 3216166181 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | No |
| Taxonomy Code | 251J00000X - Nursing Care Agency |
| Is Primary | No |
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| Is Primary | Yes |
| Taxonomy Code | 261QD1600X - Developmental Disabilities Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| Washington Timika M | Agent | 1501 Robert J. Conlan Blvd NE, Palm Bay, FL, 32905 |
| Name | Role | Address |
|---|---|---|
| WASHINGTON TIMIKA | Chief Executive Officer | 1501 Robert J. Colan Blvd NE, Palm Bay, FL, 32905 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-01-28 | 1501 Robert J. Conlan Blvd NE, Suite 110, Palm Bay, FL 32905 | No data |
| CHANGE OF MAILING ADDRESS | 2021-01-28 | 1501 Robert J. Conlan Blvd NE, Suite 110, Palm Bay, FL 32905 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-01-28 | 1501 Robert J. Conlan Blvd NE, Suite 110, Palm Bay, FL 32905 | No data |
| REGISTERED AGENT NAME CHANGED | 2019-02-15 | Washington, Timika M | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-14 |
| ANNUAL REPORT | 2023-02-16 |
| ANNUAL REPORT | 2022-01-20 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-01-10 |
| ANNUAL REPORT | 2019-02-15 |
| Florida Limited Liability | 2018-02-22 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
