| Entity Name: | AJL NURSING SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 12 Sep 2018 (6 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 08 Apr 2022 (3 years ago) |
| Document Number: | L18000217292 |
| FEI/EIN Number | 83-1882788 |
| Address: | 2090 W. EAU GALLIE BLVD, SUITE B, MELBOURNE, FL 32935 |
| Mail Address: | 4655 Salisbury Rd., SUITE 110, JACKSONVILLE, FL 32256-0957 |
| ZIP code: | 32935 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184183022 | 2019-03-19 | 2023-12-27 | 4655 SALISBURY RD, STE 110, JACKSONVILLE, FL, 322560957, US | 2090 W EAU GALLIE BLVD STE B, MELBOURNE, FL, 329353186, US | |||||||||||||||||||||||||||||
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| Phone | +1 904-733-1003 |
| Phone | +1 321-306-2551 |
| Fax | 3212413003 |
Authorized person
| Name | ROBERT G YOUNG |
| Role | SECRETARY & CAO |
| Phone | 9043339820 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | CLIA WAIVER |
| Number | 10D2163610 |
| State | FL |
| Issuer | AHCA STATE LICENSE |
| Number | 299994870 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| YOUNG, ROBERT GREG | Agent | 4655 Salisbury Rd., SUITE 110, JACKSONVILLE, FL 32256-0957 |
| Name | Role | Address |
|---|---|---|
| RUCKER, DAVID CHRISTOPHER | Chief Executive Officer | 4655 Salisbury Rd., SUITE 110 JACKSONVILLE, FL 32256-0957 |
| Name | Role | Address |
|---|---|---|
| RUCKER, DAVID CHRISTOPHER | Manager | 4655 Salisbury Rd., SUITE 110 JACKSONVILLE, FL 32256-0957 |
| FISHER, JEFFREY L | Manager | 4655 Salisbury Rd., SUITE 110 JACKSONVILLE, FL 32256-0957 |
| Name | Role | Address |
|---|---|---|
| FISHER, JEFFREY L | President | 4655 Salisbury Rd., SUITE 110 JACKSONVILLE, FL 32256-0957 |
| Name | Role | Address |
|---|---|---|
| Young, Robert Greg | Chief Financial Officer | 4655 Salisbury Rd., SUITE 110 JACKSONVILLE, FL 32256-0957 |
| Name | Role | Address |
|---|---|---|
| YOUNG, ROBERT GREG | Secretary | 4655 Salisbury Rd., SUITE 110 JACKSONVILLE, FL 32256-0957 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000080115 | CONCIERGE HOME CARE | ACTIVE | 2023-07-06 | 2028-12-31 | No data | 4655 SALISBURY RD., STE 110, JACKSONVILLE, FL, 32256 |
| G18000102426 | CHAMPION HOME HEALTH CARE | ACTIVE | 2018-09-17 | 2028-12-31 | No data | 4655 SALISBURY RD, SUITE 110, JACKSONVILLE, FL, 32256-0957 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2023-07-06 | 2090 W. EAU GALLIE BLVD, SUITE B, MELBOURNE, FL 32935 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-07-06 | YOUNG, ROBERT GREG | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-07-06 | 4655 Salisbury Rd., SUITE 110, JACKSONVILLE, FL 32256-0957 | No data |
| LC AMENDMENT | 2022-04-08 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-10-20 | 2090 W. EAU GALLIE BLVD, SUITE B, MELBOURNE, FL 32935 | No data |
| LC AMENDMENT | 2021-10-20 | No data | No data |
| LC AMENDMENT | 2019-09-30 | No data | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-11-13 |
| ANNUAL REPORT | 2024-02-06 |
| AMENDED ANNUAL REPORT | 2023-07-06 |
| ANNUAL REPORT | 2023-02-13 |
| LC Amendment | 2022-04-08 |
| ANNUAL REPORT | 2022-01-18 |
| LC Amendment | 2021-10-20 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-01-17 |
| LC Amendment | 2019-09-30 |
Date of last update: 17 Jan 2025
Sources: Florida Department of State
