| Entity Name: | HOME ANGELS CARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 14 Oct 2019 (5 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 23 Oct 2024 (4 months ago) |
| Document Number: | L19000257256 |
| FEI/EIN Number | 84-3494546 |
| Address: | 5464 ROLLINS AVENUE, JACKSONVILLE, FL 32207 |
| Mail Address: | 5464 ROLLINS AVENUE, JACKSONVILLE, FL 32207 |
| ZIP code: | 32207 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1689268963 | 2021-02-26 | 2021-03-07 | 5464 ROLLINS AVE, JACKSONVILLE, FL, 322077715, US | 5464 ROLLINS AVE, JACKSONVILLE, FL, 322077715, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 904-888-7629 |
Authorized person
| Name | EMILIYA MUSTAFAEVA |
| Role | ADMINISTRATOR |
| Phone | 9048887629 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | No |
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| Is Primary | Yes |
| Taxonomy Code | 372600000X - Adult Companion |
| Is Primary | No |
| Taxonomy Code | 376J00000X - Homemaker |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 106052200 |
| State | FL |
| Issuer | AHCA |
| Number | 236502 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MUSTAFAEVA, EMILIYA | Agent | 5464 ROLLINS AVENUE, JACKSONVILLE, FL 32207 |
| Name | Role | Address |
|---|---|---|
| MUSTAFAEVA, EMILIYA | Manager | 5464 ROLLINS AVENUE, JACKSONVILLE, FL 32207 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-10-23 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2024-10-23 | MUSTAFAEVA, EMILIYA | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-10-23 |
| ANNUAL REPORT | 2023-04-29 |
| ANNUAL REPORT | 2022-04-10 |
| ANNUAL REPORT | 2021-04-26 |
| ANNUAL REPORT | 2020-06-30 |
| Florida Limited Liability | 2019-10-14 |
Date of last update: 15 Feb 2025
Sources: Florida Department of State
