| Entity Name: | PHENOMENAL HEALTHCARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 21 Aug 2020 (4 years ago) |
| Document Number: | L20000259023 |
| FEI/EIN Number | 852806739 |
| Address: | 6815 Atlantic Boulevard, Jacksonville, FL, 32211, US |
| Mail Address: | 6815 Atlantic Boulevard, Jacksonville, FL, 32211, US |
| ZIP code: | 32211 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023603503 | 2021-03-05 | 2022-03-08 | 6815 ATLANTIC BLVD STE 3, JACKSONVILLE, FL, 322118764, US | 6815 ATLANTIC BLVD STE 3, JACKSONVILLE, FL, 322118764, US | |||||||||||||||||
|
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| Phone | +1 904-438-5837 |
Authorized person
| Name | MARLENA ELLIS |
| Role | PRESIDENT/TREASURER |
| Phone | 9044385837 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | No |
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ELLIS MARLENA S | Agent | 6815 Atlantic Boulevard, Jacksonville, FL, 32211 |
| Name | Role | Address |
|---|---|---|
| ELLIS MARLENA S | Manager | P.O. Box 3347, Jacksonville, FL, 32206 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000029423 | HOME CARE FOR THE 21ST CENTURY- JACKSONVILLE | ACTIVE | 2021-03-02 | 2026-12-31 | No data | 6815 ATLANTIC BOULEVARD, SUITE 3, JACKSONVILLE, FL, 32211 |
| G21000029480 | HOME CARE FOR THE 21ST CENTURY HH- JACKSONVILLE | ACTIVE | 2021-03-02 | 2026-12-31 | No data | 6815 ATLANTIC BOULEVARD, SUITE 3, JACKSONVILLE, FL, 32211 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-02-03 | 6815 Atlantic Boulevard, Suite 3, Jacksonville, FL 32211 | No data |
| CHANGE OF MAILING ADDRESS | 2021-02-03 | 6815 Atlantic Boulevard, Suite 3, Jacksonville, FL 32211 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-02-03 | 6815 Atlantic Boulevard, Suite 3, Jacksonville, FL 32211 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-10 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-01-27 |
| ANNUAL REPORT | 2021-02-03 |
| Florida Limited Liability | 2020-08-21 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
