| Entity Name: | EXTENDED FAMILY OF NORTH FLORIDA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 17 Jul 2018 (7 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 23 Jul 2024 (7 months ago) |
| Document Number: | L18000172383 |
| FEI/EIN Number | 83-1404661 |
| Address: | 2 Pine Cone Dr, Palm Coast, FL, 32137, US |
| Mail Address: | 2 Pine Cone Dr, Palm Coast, FL, 32137, US |
| ZIP code: | 32137 |
| County: | Flagler |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1487135620 | 2018-08-26 | 2024-07-29 | PO BOX 350373, PALM COAST, FL, 321350373, US | 21 BENNETT LN, PALM COAST, FL, 321378610, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 386-222-2791 |
| Fax | 3864012467 |
| Phone | +1 386-315-1260 |
Authorized person
| Name | MS. LILY MICHELLE KING |
| Role | OWNER |
| Phone | 3863151260 |
Taxonomy
| Taxonomy Code | 163W00000X - Registered Nurse |
| Is Primary | No |
| Taxonomy Code | 164W00000X - Licensed Practical Nurse |
| Is Primary | No |
| Taxonomy Code | 251E00000X - Home Health 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 |
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| Is Primary | No |
| Taxonomy Code | 320600000X - Intellectual and/or Developmental Disabilities Residential Treatment Facility |
| Is Primary | No |
| Taxonomy Code | 320700000X - Physical Disabilities Residential Treatment Facility |
| Is Primary | No |
| Taxonomy Code | 320900000X - Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| Is Primary | No |
| Taxonomy Code | 347C00000X - Private Vehicle |
| Is Primary | No |
| Taxonomy Code | 372600000X - Adult Companion |
| Is Primary | No |
| Taxonomy Code | 3747P1801X - Personal Care Attendant |
| Is Primary | No |
| Taxonomy Code | 374U00000X - Home Health Aide |
| Is Primary | No |
| Taxonomy Code | 376J00000X - Homemaker |
| Is Primary | No |
| Taxonomy Code | 385H00000X - Respite Care |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| King Lily M | Agent | 2 Pine Cone Dr, Palm Coast, FL, 32137 |
| Name | Role | Address |
|---|---|---|
| KING LILY M | Manager | 2 Pine Cone Dr, Palm Coast, FL, 32137 |
| King Kwaleb D | Manager | 2 Pine Cone Dr, Palm Coast, FL, 32137 |
| Name | Role | Address |
|---|---|---|
| Ellis Jazmine J | Director | 2 Pine Cone Dr, Palm Coast, FL, 32137 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-07-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-07-23 | 2 Pine Cone Dr, 350373, Palm Coast, FL 32137 | No data |
| CHANGE OF MAILING ADDRESS | 2024-07-23 | 2 Pine Cone Dr, 350373, Palm Coast, FL 32137 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-07-23 | King, Lily M | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-07-23 | 2 Pine Cone Dr, 350373, Palm Coast, FL 32137 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REINSTATEMENT | 2022-09-10 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| LC AMENDMENT | 2020-06-26 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-07-23 |
| REINSTATEMENT | 2022-09-10 |
| LC Amendment | 2020-06-26 |
| ANNUAL REPORT | 2020-03-13 |
| ANNUAL REPORT | 2019-03-16 |
| Florida Limited Liability | 2018-07-17 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
