| Entity Name: | LIGHTHOUZ HOME HEALTH CARE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 24 Jan 2019 (6 years ago) |
| Document Number: | L19000026334 |
| FEI/EIN Number | 83-3408338 |
| Address: | 1804 Guinyard Way, Orlando, FL, 32805, US |
| Mail Address: | 1804 Guinyard Way, ORLANDO, FL, 32805, US |
| ZIP code: | 32805 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962021550 | 2020-04-13 | 2020-04-13 | 6418 SEABURY WAY, ORLANDO, FL, 328181750, US | 6418 SEABURY WAY, ORLANDO, FL, 328181750, US | |||||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 407-720-9682 |
Authorized person
| Name | SEQUOIA FONSECA |
| Role | DIRECTOR |
| Phone | 4079525471 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
| Taxonomy Code | 251J00000X - Nursing Care Agency |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| Is Primary | No |
| Taxonomy Code | 261QD1600X - Developmental Disabilities Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 313M00000X - Nursing Facility/Intermediate Care Facility |
| Is Primary | No |
| Taxonomy Code | 320900000X - Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| Is Primary | No |
| Taxonomy Code | 385HR2060X - Child Intellectual and/or Developmental Disabilities Respite Care |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 104342000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FONSECA SEQUOIA L | Agent | 6418 SEABURY WAY, ORLANDO, FL, 32818 |
| Name | Role | Address |
|---|---|---|
| FONSECA Eric ASr. | Authorized Member | 6418 SEABURY WAY, ORLANDO, FL, 32818 |
| Elibert Miguerline B | Authorized Member | 708 Tobie Court, Orlando, FL, 32825 |
| Name | Role | Address |
|---|---|---|
| Fonseca Sequoia L | Manager | 6418 SEABURY WAY, ORLANDO, FL, 32818 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-04-30 | 1804 Guinyard Way, Orlando, FL 32805 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-12 | 1804 Guinyard Way, Orlando, FL 32805 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-04-30 | FONSECA, SEQUOIA L | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-07-02 |
| ANNUAL REPORT | 2021-04-12 |
| ANNUAL REPORT | 2020-04-30 |
| Florida Limited Liability | 2019-01-24 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
