| Entity Name: | MAYBELLE GROUP HOME LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 13 Jan 2020 (5 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 13 Jul 2020 (5 years ago) |
| Document Number: | L20000018697 |
| FEI/EIN Number | 85-1431806 |
| Address: | 7207 LAKESHORE DR, TAMPA, FL, 33604, US |
| Mail Address: | 7207 LAKESHORE DR, TAMPA, FL, 33604 |
| ZIP code: | 33604 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972365799 | 2024-01-26 | 2024-01-26 | 7202 LAKESHORE DR, TAMPA, FL, 33604, US | 7207 LAKESHORE DRIVE, TAMPA, FL, 33604, US | |||||||||||||||||||||||||||
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| Phone | +1 813-966-7399 |
| Fax | 8132126002 |
Authorized person
| Name | WAVENEY GITTENS-WILLIAMS |
| Role | ASSISTANT ADMINISTRATOR |
| Phone | 8139667399 |
Taxonomy
| Taxonomy Code | 251C00000X - Developmentally Disabled Services Day Training Agency |
| Is Primary | No |
| Taxonomy Code | 251J00000X - Nursing Care Agency |
| Is Primary | No |
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| Is Primary | No |
| Taxonomy Code | 364SL0600X - Long-Term Care Clinical Nurse Specialist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LINGONDO SOPHIE E | Agent | 7207 LAKESHORE DR, TAMPA, FL, 33604 |
| Name | Role | Address |
|---|---|---|
| LINGONDO SOPHIE E | Manager | 7207 LAKESHORE DR, TAMPA, FL, 33604 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-03-13 | 7207 LAKESHORE DR, TAMPA, FL 33604 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-03-13 | LINGONDO, SOPHIE E | No data |
| LC AMENDMENT | 2020-07-13 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-28 |
| ANNUAL REPORT | 2023-01-05 |
| ANNUAL REPORT | 2022-03-13 |
| ANNUAL REPORT | 2021-01-19 |
| LC Amendment | 2020-07-13 |
| Florida Limited Liability | 2020-01-13 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
