| Entity Name: | AMITY HOME CARE SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 03 Apr 2019 (6 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 28 Oct 2020 (4 years ago) |
| Document Number: | L19000092418 |
| FEI/EIN Number | 83-4449442 |
| Address: | 745 US HWY 1, North Palm Beach, FL, 33408, US |
| Mail Address: | 745 US HWY 1, North Palm Beach, FL, 33408, US |
| ZIP code: | 33408 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497319867 | 2019-04-30 | 2023-07-31 | 4685 VILLAS SANTORINI DR, LAKE WORTH, FL, 334615176, US | 745 US HWY 1 SUITE 301;302;309, NORTH PALM BEACH, FL, 33408, US | |||||||||||||||||||||||||
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| Phone | +1 561-461-6737 |
| Fax | 8508520127 |
Authorized person
| Name | FERNANDE CLERIZIER |
| Role | CEO |
| Phone | 5614616737 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | No |
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000111222333 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Clerizier Fernande | Agent | 4685 Villas Santorini Dr., Lake Worth, FL, 33461 |
| Name | Role | Address |
|---|---|---|
| CLERIZIER FERNANDE | Owner | 4685 VILLAS SANTORINI DRIVE, LAKE WORTH, FL, 33461 |
| Name | Role | Address |
|---|---|---|
| SAINT FLEUR WESNER | Chairman | 4685 VILLAS SANTORINI DRIVE, LAKE WORTH, FL, 33461 |
| Name | Role | Address |
|---|---|---|
| SAINT FLEUR WESNER | Officer | 4685 VILLAS SANTORINI DRIVE, LAKE WORTH, FL, 33461 |
| Name | Role | Address |
|---|---|---|
| Herzog Lori, RN | Auth | 745 US HWY 1, North Palm Beach, FL, 33408 |
| Name | Role | Address |
|---|---|---|
| Pierre-Duquene Brunette, RN | Alte | 745 US HWY 1, North Palm Beach, FL, 33408 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-03-15 | 745 US HWY 1, Suite 301-302-309, North Palm Beach, FL 33408 | No data |
| CHANGE OF MAILING ADDRESS | 2022-03-15 | 745 US HWY 1, Suite 301-302-309, North Palm Beach, FL 33408 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-03-15 | 4685 Villas Santorini Dr., Lake Worth, FL 33461 | No data |
| LC AMENDMENT | 2020-10-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-03-19 | Clerizier, Fernande | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-11 |
| ANNUAL REPORT | 2023-05-15 |
| ANNUAL REPORT | 2022-03-15 |
| ANNUAL REPORT | 2021-02-10 |
| LC Amendment | 2020-10-28 |
| ANNUAL REPORT | 2020-03-19 |
| Florida Limited Liability | 2019-04-03 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
