| Entity Name: | CAROLYN CLANTON ALF, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 10 Jul 2019 (6 years ago) |
| Document Number: | L19000179851 |
| FEI/EIN Number | 84-2775810 |
| Address: | 1146 HAMILTON AVENUE, JENNINGS, FL 32053 |
| Mail Address: | 1146 HAMILTON AVENUE, JENNINGS, FL 32053 |
| ZIP code: | 32053 |
| County: | Hamilton |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003434028 | 2020-07-07 | 2022-04-28 | 1146 HAMILTON AVE, JENNINGS, FL, 320532253, US | 1146 HAMILTON AVE, JENNINGS, FL, 320532253, US | |||||||||||||||
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| Phone | +1 229-300-5469 |
| Phone | +1 386-938-4102 |
Authorized person
| Name | MS. HEATHER N DAVIS |
| Role | ADMINISTRATOR/OWNER |
| Phone | 3868551357 |
Taxonomy
| Taxonomy Code | 3104A0625X - Assisted Living Facility (Mental Illness) |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DAVIS, HEATHER | Agent | 1146 HAMILTON AVENUE, JENNINGS, FL 32053 |
| Name | Role | Address |
|---|---|---|
| Whitehead III, Rupert | Manager | 4440 McMullen Drive, Valdosta, GA 31606 |
| DAVIS, HEATHER | Manager | 1146 HAMILTON AVENUE, JENNINGS, FL 32053 |
| Owen III , William | Manager | 3786 NW 86th BLVD, Jasper, FL 32052 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-18 |
| ANNUAL REPORT | 2023-02-08 |
| ANNUAL REPORT | 2022-02-19 |
| ANNUAL REPORT | 2021-04-07 |
| ANNUAL REPORT | 2020-06-22 |
| Florida Limited Liability | 2019-07-10 |
Date of last update: 16 Jan 2025
Sources: Florida Department of State
