| Entity Name: | RACHELLE HOMEHEALTH CARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 19 Sep 2019 (5 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | L19000237735 |
| FEI/EIN Number | 84-3232818 |
| Address: | 1316 MULL STREET, JACKSONVILLE, FL, 32205, US |
| Mail Address: | 1316 MULL STREET, JACKSONVILLE, FL, 32205, US |
| ZIP code: | 32205 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124628565 | 2020-10-26 | 2020-10-26 | 8539 GATE PKWY W UNIT 9134, JACKSONVILLE, FL, 322161037, US | 8539 GATE PKWY W UNIT 9134, JACKSONVILLE, FL, 322161037, US | |||||||||||||||||||
|
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| Phone | +1 904-415-0913 |
Authorized person
| Name | RACHELLE WILLIAMS |
| Role | REGISTER NURSE |
| Phone | 9044150913 |
Taxonomy
| Taxonomy Code | 320900000X - Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 102108200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WILLIAMS RACHELLE | Agent | 1316 MULL STREET, JACKSONVILLE, FL, 32205 |
| Name | Role | Address |
|---|---|---|
| WILLIAMS RACHELLE | Managing Member | 1316 MULL STREET, JACKSONVILLE, FL, 32205 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| REINSTATEMENT | 2021-07-07 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-07-07 | 1316 MULL STREET, JACKSONVILLE, FL 32205 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-07-07 | WILLIAMS, RACHELLE | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-07-07 | 1316 MULL STREET, JACKSONVILLE, FL 32205 | No data |
| CHANGE OF MAILING ADDRESS | 2020-12-11 | 1316 MULL STREET, JACKSONVILLE, FL 32205 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2021-07-07 |
| Florida Limited Liability | 2019-09-19 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
