| Entity Name: | SAFE HAVEN HOMECARE SERVICES L.L.C |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 07 Mar 2018 (7 years ago) |
| Last Event: | LC AMENDMENT AND NAME CHANGE |
| Event Date Filed: | 06 Jan 2020 (5 years ago) |
| Document Number: | L18000060815 |
| FEI/EIN Number | 84-4174269 |
| Address: | 6239 Edgewater DR Building D suite D10-A, ORLANDO, FL, 32810, US |
| Mail Address: | 6239 Edgewater DR Building D suite D-10-A, ORLANDO, FL, 32818, US |
| ZIP code: | 32810 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124641154 | 2020-05-26 | 2022-11-29 | 6239 EDGEWATER DR SUITE D10-A, ORLANDO, FL, 328105258, US | 6239 EDGEWATER DR STE D10-A, ORLANDO, FL, 328104736, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 407-866-5644 |
| Fax | 4077305366 |
| Fax | 4072379182 |
Authorized person
| Name | RENEE R JORDAN |
| Role | DIRECTOR |
| Phone | 4074510245 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | No |
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| Is Primary | Yes |
| Taxonomy Code | 320900000X - Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| Is Primary | No |
| Taxonomy Code | 376J00000X - Homemaker |
| Is Primary | No |
| Taxonomy Code | 385H00000X - Respite Care |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 105983400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Jordan Renee R | Agent | 6239 Edgewater DR Building D suite D-10-A, ORLANDO, FL, 32810 |
| Name | Role | Address |
|---|---|---|
| Jordan RENEE R | Auth | 6239 Edgewater DR Building D suite D-10-A, ORLANDO, FL, 32810 |
| Name | Role | Address |
|---|---|---|
| Jordan Renee | Manager | 6239 Edgewater DR Building D suite D-10-A, ORLANDO, FL, 32810 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-01-21 | 6239 Edgewater DR Building D suite D10-A, ORLANDO, FL 32810 | No data |
| CHANGE OF MAILING ADDRESS | 2022-01-21 | 6239 Edgewater DR Building D suite D10-A, ORLANDO, FL 32810 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-01-21 | Jordan, Renee R | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-01-21 | 6239 Edgewater DR Building D suite D-10-A, ORLANDO, FL 32810 | No data |
| LC AMENDMENT AND NAME CHANGE | 2020-01-06 | SAFE HAVEN HOMECARE SERVICES L.L.C | No data |
| REINSTATEMENT | 2019-09-30 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-13 |
| ANNUAL REPORT | 2023-02-06 |
| ANNUAL REPORT | 2022-01-21 |
| ANNUAL REPORT | 2021-03-06 |
| AMENDED ANNUAL REPORT | 2020-11-04 |
| ANNUAL REPORT | 2020-05-05 |
| LC Amendment and Name Change | 2020-01-06 |
| REINSTATEMENT | 2019-09-30 |
| Florida Limited Liability | 2018-03-07 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
