| Entity Name: | COX ADULT LIVING FACILITY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 27 Mar 2018 (7 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 19 Jul 2022 (3 years ago) |
| Document Number: | L18000078672 |
| FEI/EIN Number | 59-3221886 |
| Address: | 1906 OSCAR COX TRAIL, PLANT CITY, FL, 33567, US |
| Mail Address: | 1906 OSCAR COX TRAIL, PLANT CITY, FL, 33567, US |
| ZIP code: | 33567 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1740689553 | 2014-08-18 | 2014-08-18 | 1906 OSCAR COX TRL, PLANT CITY, FL, 335673795, US | 1906 OSCAR COX TRL, PLANT CITY, FL, 335673795, US | |||||||||||||||||||||||
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| Phone | +1 813-737-1551 |
Authorized person
| Name | CONSTANCE THOMAS |
| Role | OWNER/ADMINISTRATOR |
| Phone | 8137371551 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL8319 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 140192100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| THOMAS CONSTANCE D | Agent | 5402 SMITH RYALS ROAD, PLANT CITY, FL, 33567 |
| Name | Role | Address |
|---|---|---|
| THOMAS CONSTANCE D | President | 1906 OSCAR COX TRAIL, PLANT CITY, FL, 33567 |
| Name | Role | Address |
|---|---|---|
| SHAW JOSLIN | Manager | 1906 OSCAR COX TRAIL, PLANT CITY, FL, 33567 |
| HORTON LOLITA | Manager | 1922 OSCAR COX TRAIL, PLANT CITY, FL, 33567 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2022-07-19 | No data | No data |
| REINSTATEMENT | 2021-05-25 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2021-05-25 | THOMAS, CONSTANCE D | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-10 |
| ANNUAL REPORT | 2023-01-12 |
| LC Amendment | 2022-07-19 |
| ANNUAL REPORT | 2022-01-25 |
| REINSTATEMENT | 2021-05-25 |
| Florida Limited Liability | 2018-03-27 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
