| Entity Name: | GENMAR'S HOME CARE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 08 Jan 2020 (5 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 13 May 2020 (5 years ago) |
| Document Number: | L20000015122 |
| FEI/EIN Number | 844201283 |
| Address: | 4784 HICKORY STREAM LANE, MULBERRY, FL, 33860 |
| Mail Address: | 4784 HICKORY STREAM LANE, MULBERRY, FL, 33860 |
| ZIP code: | 33860 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164079943 | 2019-08-26 | 2019-08-26 | 4784 HICKORY STREAM LN, MULBERRY, FL, 338607914, US | 4784 HICKORY STREAM LN, MULBERRY, FL, 338607914, US | |||||||||||||||||||||
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| Phone | +1 813-679-9469 |
| Fax | 8639435201 |
Authorized person
| Name | MARIA VIRGEN SANTAELLA |
| Role | LPN |
| Phone | 8136799469 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1194203471 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SANTAELLA MARIA V | Agent | 4784 HICKORY STREAM LANE, MULBERRY, FL, 33860 |
| Name | Role | Address |
|---|---|---|
| SANTAELLA MARIA V | Manager | 4784 HICKORY STREAM LN, MULBERRY, FL, 33860 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2020-05-13 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-15 |
| ANNUAL REPORT | 2024-01-19 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-01-10 |
| ANNUAL REPORT | 2021-01-09 |
| LC Amendment | 2020-05-13 |
| Florida Limited Liability | 2020-01-08 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
