| Entity Name: | ANNA VILLA HOME, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 05 Mar 2020 (5 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 09 Oct 2024 (4 months ago) |
| Document Number: | L20000069958 |
| FEI/EIN Number | N/A |
| Address: | 921 NW 183 DR., MIAMI, FL 33169 |
| Mail Address: | 921 NW 183 DR., MIAMI, FL 33169 |
| ZIP code: | 33169 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013614221 | 2023-02-08 | 2023-02-08 | 921 NW 183RD DR, MIAMI, FL, 331694263, US | 921 NW 183RD DR, MIAMI, FL, 331694263, US | |||||||||||||||||||||||||||
|
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| Phone | +1 786-317-7227 |
Authorized person
| Name | MS. ANNA PALMER |
| Role | OWNER |
| Phone | 7863177227 |
Taxonomy
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| Is Primary | No |
| Taxonomy Code | 3747A0650X - Attendant Care Provider |
| Is Primary | Yes |
| Taxonomy Code | 385H00000X - Respite Care |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 115322500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PALMER, ANNA M | Agent | 921 NW 183 DR., MIAMI, FL 33169 |
| Name | Role | Address |
|---|---|---|
| PALMER, ANNA M, MGRM | Managing Member | 921 NW 183 DR., MIAMI, FL 33169 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-10-09 | 921 NW 183 DR., MIAMI, FL 33169 | No data |
| REINSTATEMENT | 2024-10-09 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-10-09 | 921 NW 183 DR., MIAMI, FL 33169 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-10-09 | PALMER, ANNA M | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| REINSTATEMENT | 2022-10-10 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| REINSTATEMENT | 2021-10-15 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-05 |
| REINSTATEMENT | 2024-10-09 |
| ANNUAL REPORT | 2023-04-04 |
| REINSTATEMENT | 2022-10-10 |
| REINSTATEMENT | 2021-10-15 |
| Florida Limited Liability | 2020-03-05 |
Date of last update: 16 Jan 2025
Sources: Florida Department of State
