| Entity Name: | GRACEFULLY AGING, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 13 Aug 2018 (6 years ago) |
| Document Number: | L18000193713 |
| FEI/EIN Number | 831527885 |
| Address: | 1950 LEE RD, WINTER PARK, FL, 32789, US |
| Mail Address: | 1950 LEE RD, WINTER PARK, FL, 32789, US |
| ZIP code: | 32789 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174088827 | 2019-02-06 | 2021-06-02 | 1837 LOCHSHYRE LOOP, OCOEE, FL, 347619160, US | 1837 LOCHSHYRE LOOP, OCOEE, FL, 347619160, US | |||||||||||||||||||
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| Phone | +1 407-744-9043 |
Authorized person
| Name | NAKIA STARKER |
| Role | MANAGER |
| Phone | 4078445840 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1578032967 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| STARKER NAKIA | Agent | 1950 Lee Road, Winter Park, FL, 32789 |
| Name | Role | Address |
|---|---|---|
| STARKER NAKIA | Manager | 1950 Lee Road, Winter Park, FL, 32789 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000163268 | G A TRANSPORTS | ACTIVE | 2021-12-08 | 2026-12-31 | No data | 1950 LEE ROAD, STE 114, WINTER PARK, FL, 32789 |
| G21000156165 | DIVINE WELLNESS & SPA | ACTIVE | 2021-11-22 | 2026-12-31 | No data | 1950 LEE ROAD, STE 114, WINTER PARK, FL, 32789 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-05-02 | 1950 Lee Road, Ste 114, Winter Park, FL 32789 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-02-08 | 1950 LEE RD, STE 114, WINTER PARK, FL 32789 | No data |
| CHANGE OF MAILING ADDRESS | 2022-02-02 | 1950 LEE RD, STE 114, WINTER PARK, FL 32789 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-02 |
| ANNUAL REPORT | 2023-05-01 |
| ANNUAL REPORT | 2022-04-25 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-06-04 |
| ANNUAL REPORT | 2019-04-29 |
| Florida Limited Liability | 2018-08-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
