| Entity Name: | OHANA IN HOME SENIOR CARE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 08 Feb 2019 (6 years ago) |
| Document Number: | L19000039507 |
| FEI/EIN Number | 83-3638233 |
| Address: | 105 MARY BROWN ROAD, QUINCY, FL 32352 |
| Mail Address: | 105 MARY BROWN ROAD, QUINCY, FL 32352 |
| ZIP code: | 32352 |
| County: | Gadsden |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720691082 | 2020-08-26 | 2020-08-26 | 105 MARY BROWN RD, QUINCY, FL, 323520394, US | 421 W GEORGIA ST, TALLAHASSEE, FL, 323011011, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 850-274-0414 |
| Phone | +1 850-270-7331 |
Authorized person
| Name | NAEISHA SANDERS |
| Role | OWNER/ ADMINISTRATOR |
| Phone | 8502707331 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
| Taxonomy Code | 320900000X - Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| Is Primary | No |
| Taxonomy Code | 385H00000X - Respite Care |
| Is Primary | No |
| Taxonomy Code | 385HR2060X - Child Intellectual and/or Developmental Disabilities Respite Care |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 105445600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SANDERS, NAEISHA S | Agent | 105 MARY BROWN ROAD, QUINCY, FL 32352 |
| Name | Role | Address |
|---|---|---|
| SANDERS, NAEISHA S | Manager | 105 MARY BROWN ROAD, QUINCY, FL 32352 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-12 | 105 MARY BROWN ROAD, QUINCY, FL 32352 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-28 |
| ANNUAL REPORT | 2023-04-12 |
| ANNUAL REPORT | 2022-04-30 |
| ANNUAL REPORT | 2021-04-01 |
| ANNUAL REPORT | 2020-06-08 |
| Florida Limited Liability | 2019-02-08 |
Date of last update: 17 Jan 2025
Sources: Florida Department of State
