| Entity Name: | ANGELS OF HOPE HOME CARE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 29 Nov 2018 (6 years ago) |
| Document Number: | L18000276348 |
| FEI/EIN Number | 83-2645525 |
| Address: | 619 ROLLINS DR, DAVENPORT, FL, 33837 |
| Mail Address: | 619 ROLLINS DR, DAVENPORT, FL, 33837 |
| ZIP code: | 33837 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194383356 | 2019-06-03 | 2019-06-03 | 619 ROLLINS DR, DAVENPORT, FL, 338377218, US | 619 ROLLINS DR, DAVENPORT, FL, 338377218, US | |||||||||||||||||||||
|
|||||||||||||||||||||||||
| Phone | +1 863-438-6331 |
| Phone | +1 407-692-7651 |
Authorized person
| Name | MIGUEL ANGEL MARQUEZ |
| Role | OWNER |
| Phone | 4076927651 |
Taxonomy
| Taxonomy Code | 261QD1600X - Developmental Disabilities Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | M622541861230 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANGELS OF HOPE HOME CARE LLC | 2023 | 832645525 | 2024-09-01 | ANGELS OF HOPE HOME CARE LLC | 13 | |||||||||||||||||||||||
|
||||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2024-09-01 |
| Name of individual signing | SHIRLEY HORNER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-03-01 |
| Business code | 621610 |
| Sponsor’s telephone number | 4074863798 |
| Plan sponsor’s address | 619 ROLLINS DR, DAVENPORT, FL, 33837 |
Signature of
| Role | Plan administrator |
| Date | 2023-09-13 |
| Name of individual signing | SHIRLEY HORNER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| MARQUEZ MIGUEL | Agent | 619 ROLLINS DR, DEVENPORT, FL, 33837 |
| Name | Role | Address |
|---|---|---|
| MARQUEZ MIGUEL A | Manager | 619 ROLLINS DR, DAVENPORT, FL, 33837 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000002674 | ANGELS OF HOPE ABA THERAPY CENTER | ACTIVE | 2020-01-07 | 2025-12-31 | No data | 619 ROLLINS DR, DAVENPORT, FL, 33837 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-01 |
| ANNUAL REPORT | 2023-01-24 |
| ANNUAL REPORT | 2022-03-15 |
| ANNUAL REPORT | 2021-04-03 |
| ANNUAL REPORT | 2020-06-24 |
| ANNUAL REPORT | 2019-04-29 |
| Florida Limited Liability | 2018-11-29 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
