| Entity Name: | GREATER VISION HEALTHCARE SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 10 Jul 2018 (7 years ago) |
| Document Number: | L18000165956 |
| FEI/EIN Number | 37-1912905 |
| Address: | 788 Montgomery Ave, Ocoee, FL 34761 |
| Mail Address: | 788 Montgomery Ave, Ocoee, FL 34761 |
| ZIP code: | 34761 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366984627 | 2016-11-17 | 2022-09-19 | 788 MONTGOMERY AVE STE 200, OCOEE, FL, 347613102, US | 788 MONTGOMERY AVE STE 200, OCOEE, FL, 347613102, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 407-473-2837 |
| Fax | 4076142420 |
Authorized person
| Name | VERNET STALLWORTH |
| Role | OWNER/PRESIDENT |
| Phone | 4074732837 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
| Taxonomy Code | 251J00000X - Nursing Care Agency |
| Is Primary | No |
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 100212300 |
| State | FL |
| Issuer | MEDICAID |
| Number | 112640700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| STALLWORTH, VERNET | Agent | 788 Montgomery Ave, Ocoee, FL 34761 |
| Name | Role | Address |
|---|---|---|
| Stallworth, Vernet | President | 788 Montgomery Ave, Ocoee, FL 34761 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000115777 | GREATER VISION HOME CARE | ACTIVE | 2016-10-25 | 2026-12-31 | No data | 788 MONTGOMERY AVE, OCOEE, FL, 34761 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-03-01 | 788 Montgomery Ave, Ocoee, FL 34761 | No data |
| CHANGE OF MAILING ADDRESS | 2021-03-01 | 788 Montgomery Ave, Ocoee, FL 34761 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-03-01 | 788 Montgomery Ave, Ocoee, FL 34761 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-31 |
| ANNUAL REPORT | 2023-05-02 |
| ANNUAL REPORT | 2022-04-27 |
| AMENDED ANNUAL REPORT | 2021-03-11 |
| ANNUAL REPORT | 2021-03-01 |
| ANNUAL REPORT | 2020-03-12 |
| ANNUAL REPORT | 2019-04-01 |
| Florida Limited Liability | 2018-07-10 |
Date of last update: 17 Jan 2025
Sources: Florida Department of State
