| Entity Name: | GUEST HOUSE OCALA OUTPATIENT RECOVERY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 13 Dec 2019 (5 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 27 Dec 2019 (5 years ago) |
| Document Number: | L19000299063 |
| FEI/EIN Number | 84-4064962 |
| Address: | 2233 E Fort King Street Ste A, OCALA, FL 33471 |
| Mail Address: | PO Box 190, Silver Springs, FL 34489-0190 |
| ZIP code: | 33471 |
| County: | Glades |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295374940 | 2019-12-29 | 2019-12-29 | 2233 E FORT KING ST STE A, OCALA, FL, 344712563, US | 2233 E FORT KING ST STE A, OCALA, FL, 344712563, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 855-483-7800 |
| Fax | 3525095891 |
Authorized person
| Name | MS. JUDITH T CRANE |
| Role | CEO |
| Phone | 8554837800 |
Taxonomy
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 324500000X - Substance Abuse Rehabilitation Facility |
| Is Primary | No |
Other Provider Identifiers
| Issuer | NPI NUMBER |
| Number | 1003471202 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CRANE, JUDITH T | Agent | 1313 SE 18TH AVENUE, OCALA, FL 33471 |
| Name | Role | Address |
|---|---|---|
| CRANE, JUDITH T | Manager | 1313 SE 18TH AVENUE, OCALA, FL 33471 |
| Name | Role | Address |
|---|---|---|
| West, JOHN ALAN | Vice President | 1313 SE 18TH AVENUE, OCALA, FL 33471 |
| Name | Role | Address |
|---|---|---|
| FUNGAROLI, RICHARD (RICK) | Chief Operating Officer | 1313 SE 18TH AVENUE, OCALA, FL 33471 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-01-10 | 2233 E Fort King Street Ste A, OCALA, FL 33471 | No data |
| CHANGE OF MAILING ADDRESS | 2023-01-19 | 2233 E Fort King Street Ste A, OCALA, FL 33471 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-01-07 | 1313 SE 18TH AVENUE, OCALA, FL 33471 | No data |
| LC AMENDMENT | 2019-12-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-10 |
| ANNUAL REPORT | 2023-01-19 |
| ANNUAL REPORT | 2022-01-20 |
| ANNUAL REPORT | 2021-01-12 |
| ANNUAL REPORT | 2020-01-07 |
| LC Amendment | 2019-12-27 |
| Florida Limited Liability | 2019-12-13 |
Date of last update: 16 Jan 2025
Sources: Florida Department of State
