| Entity Name: | DRAGONFLY SUPPORT COORDINATION, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 25 Aug 2020 (4 years ago) |
| Date of dissolution: | 02 Oct 2023 (a year ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 02 Oct 2023 (a year ago) |
| Document Number: | L20000263118 |
| FEI/EIN Number | 85-2844810 |
| Address: | 3216 NW 47TH PLACE, GAINESVILLE, FL 32605 |
| Mail Address: | 3216 NW 47TH PLACE, GAINESVILLE, FL 32605 |
| ZIP code: | 32605 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346993896 | 2022-02-03 | 2022-02-03 | 3216 NW 47TH PL, GAINESVILLE, FL, 326051100, US | 3216 NW 47TH PL, GAINESVILLE, FL, 326051100, US | |||||||||||||||||||
|
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| Phone | +1 352-262-7672 |
Authorized person
| Name | SHERRY JOHNSON |
| Role | WAIVER SUPPORT COORDINATOR |
| Phone | 3869655418 |
Taxonomy
| Taxonomy Code | 171M00000X - Case Manager/Care Coordinator |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 110051800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BELCHER, MICHELLE | Agent | 3216 NW 47TH PLACE, GAINESVILLE, FL 32605 |
| Name | Role | Address |
|---|---|---|
| LEON, CHARISE | Manager | 5736 SW 40TH PLACE, OCALA, FL 34474 |
| JOHNSON, SHERRY | Manager | 1020 SW YORKTOWN GLEN, LAKE CITY, FL 32025 |
| Lomax, Charles Martin | Manager | 3159 172nd St, Lake City, FL 32024 |
| Belcher, Michelle Ann | Manager | 3216 NW 47TH PLACE, GAINESVILLE, FL 32605 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2023-10-02 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2023-10-02 |
| ANNUAL REPORT | 2023-03-10 |
| ANNUAL REPORT | 2022-03-31 |
| ANNUAL REPORT | 2021-02-22 |
| Florida Limited Liability | 2020-08-25 |
Date of last update: 15 Jan 2025
Sources: Florida Department of State
