| Entity Name: | NIVLEM COMPANION & HOMEMAKER CARE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 02 Mar 2020 (5 years ago) |
| Document Number: | L20000068431 |
| FEI/EIN Number | 843206522 |
| Address: | 10810 Boyette Rd, Riverview, FL, 33569, US |
| Mail Address: | PO Box 513, Riverview, FL, 33568, US |
| ZIP code: | 33569 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598416166 | 2022-01-14 | 2022-01-14 | PO BOX 513, RIVERVIEW, FL, 335680513, US | 12948 TRADE PORT PL, RIVERVIEW, FL, 335794269, US | |||||||||||||||||||
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| Phone | +1 813-770-3815 |
Authorized person
| Name | MELLVVA GREEN |
| Role | PROVIDER |
| Phone | 8137703815 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1821749706 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GREEN MELLVVA C | Agent | 10810 Boyette Rd, Riverview, FL, 33569 |
| Name | Role | Address |
|---|---|---|
| GREEN Mellvva C | Chief Executive Officer | 10810 Boyette Rd, Riverview, FL, 33569 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-27 | 10810 Boyette Rd, 513, Riverview, FL 33569 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-27 | 10810 Boyette Rd, 513, Riverview, FL 33569 | No data |
| CHANGE OF MAILING ADDRESS | 2021-04-23 | 10810 Boyette Rd, 513, Riverview, FL 33569 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-27 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-04-15 |
| ANNUAL REPORT | 2021-04-23 |
| Florida Limited Liability | 2020-03-02 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
