| Entity Name: | ABUNDANT LIFE NURSING LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 18 Dec 2018 (6 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 21 Feb 2020 (5 years ago) |
| Document Number: | L18000290078 |
| FEI/EIN Number | 83-2910129 |
| Address: | 2799 W Old Hwy 441, Mount Dora, FL, 32757, US |
| Mail Address: | 2799 W Old Hwy 441, Mount Dora, FL, 32757, US |
| ZIP code: | 32757 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356813885 | 2018-12-21 | 2024-05-29 | 2280 W OLD US HIGHWAY 441, MOUNT DORA, FL, 327573508, US | 2799 W OLD US HIGHWAY 441, MOUNT DORA, FL, 327573536, US | |||||||||||||||||||
|
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| Phone | +1 352-250-2748 |
Authorized person
| Name | PATRICIA ALLEN |
| Role | OWNER/PRESIDENT |
| Phone | 3522502748 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 105940100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ALLEN PATRICIA | Agent | 2799 W Old Hwy 441, Mount Dora, FL, 32757 |
| Name | Role | Address |
|---|---|---|
| ALLEN PATRICIA | President | 2799 W OLD HWY 441, MOUNT DORA, FL, 32757 |
| Name | Role | Address |
|---|---|---|
| ALLEN PATRICIA | Manager | 2799 W Old Hwy 441, Mount Dora, FL, 32757 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-24 | 2799 W Old Hwy 441, Mount Dora, FL 32757 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-24 | 2799 W Old Hwy 441, Mount Dora, FL 32757 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-24 | 2799 W Old Hwy 441, Mount Dora, FL 32757 | No data |
| LC AMENDMENT | 2020-02-21 | No data | No data |
| LC STMNT OF RA/RO CHG | 2019-02-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-01 |
| AMENDED ANNUAL REPORT | 2023-04-24 |
| ANNUAL REPORT | 2023-02-06 |
| ANNUAL REPORT | 2022-02-08 |
| AMENDED ANNUAL REPORT | 2021-05-04 |
| ANNUAL REPORT | 2021-01-28 |
| LC Amendment | 2020-02-21 |
| ANNUAL REPORT | 2020-01-08 |
| CORLCRACHG | 2019-02-25 |
| ANNUAL REPORT | 2019-02-06 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
