| Entity Name: | ELSYOFF CARE CENTER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 31 Jul 2020 (5 years ago) |
| Document Number: | L20000229866 |
| FEI/EIN Number | 85-2470315 |
| Address: | 1727 NW 19TH TERR, CAPE CORAL, FL, 33993, US |
| Mail Address: | 1727 NW 19TH TERR, CAPE CORAL, FL, 33993, US |
| ZIP code: | 33993 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619578192 | 2020-11-02 | 2020-11-02 | 1727 NW 19TH TER, CAPE CORAL, FL, 339934915, US | 1727 NW 19TH TER, CAPE CORAL, FL, 339934915, US | |||||||||||||||||||||
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| Phone | +1 239-312-8316 |
| Fax | 2393128320 |
Authorized person
| Name | MAILIN FREEMAN |
| Role | OWNER |
| Phone | 2393128316 |
Taxonomy
| Taxonomy Code | 261QD1600X - Developmental Disabilities Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | NA |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FREEMAN RODRIGUEZ MAILIN | Agent | 1727 NW 19 TER, CAPE CORAL, FL, 33993 |
| Name | Role | Address |
|---|---|---|
| FREEMAN RODRIGUEZ MAILIN | Manager | 1727 NW 19TH TERR, CAPE CORAL, FL, 33993 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2021-03-02 | 1727 NW 19 TER, CAPE CORAL, FL 33993 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-11-13 | 1727 NW 19TH TERR, CAPE CORAL, FL 33993 | No data |
| CHANGE OF MAILING ADDRESS | 2020-11-13 | 1727 NW 19TH TERR, CAPE CORAL, FL 33993 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-25 |
| ANNUAL REPORT | 2023-03-15 |
| ANNUAL REPORT | 2022-04-14 |
| ANNUAL REPORT | 2021-03-02 |
| Florida Limited Liability | 2020-07-31 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
