| Entity Name: | LEE'S LOVE AND CARE "LLC" |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 31 Jan 2020 (5 years ago) |
| Document Number: | L20000037580 |
| FEI/EIN Number | 84-4599312 |
| Address: | 2161 WILBERFORCE RD, JACKSONVILLE, FL 32209 |
| Mail Address: | 2161 WILBERFORCE RD, JACKSONVILLE, FL 32209 |
| ZIP code: | 32209 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184334948 | 2022-12-01 | 2024-05-16 | 8278 GOLDEN BAMBOO DR, DINSMORE, FL, 322196012, US | 8278 GOLDEN BAMBOO DR, JACKSONVILLE, FL, 322196012, US | |||||||||||||||||||||||
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| Phone | +1 904-616-8677 |
Authorized person
| Name | DEREKIA JOHNSON |
| Role | OWNER |
| Phone | 9046168677 |
Taxonomy
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| Is Primary | No |
| Taxonomy Code | 3747P1801X - Personal Care Attendant |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 115562800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| JOHNSIN, DEREKIA N | Agent | 2161 WILBERFORCE RD, JACKSONVILLE, FL 32209 |
| Name | Role | Address |
|---|---|---|
| JOHNSON, DEREKIA N | Manager | 2161 WILBERFORCE RD, JACKSONVILLE, FL 32209 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-30 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-04-29 |
| Florida Limited Liability | 2020-01-31 |
Date of last update: 15 Feb 2025
Sources: Florida Department of State
