| Entity Name: | CARE COORDINATION MANAGEMENT GROUP LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 30 Nov 2020 (4 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 29 Mar 2021 (4 years ago) |
| Document Number: | L20000373203 |
| FEI/EIN Number | 85-4205143 |
| Address: | 7775 134TH ST, SEBASTIAN, FL 32958 |
| Mail Address: | 7775 134TH ST, SEBASTIAN, FL 32958 |
| ZIP code: | 32958 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215680475 | 2022-01-28 | 2022-01-28 | 7775 134TH ST, SEBASTIAN, FL, 329583740, US | 7775 134TH ST, SEBASTIAN, FL, 329583740, US | |||||||||||||||||||
|
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| Phone | +1 772-473-4151 |
Authorized person
| Name | DENA CASSIDENTE |
| Role | CO OWNER |
| Phone | 7725392680 |
Taxonomy
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 109892700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| K12 TAX SERVICES INC | Agent | 9432 N US HIGHWAY 1, SEBASTIAN, FL 32958 |
| Name | Role | Address |
|---|---|---|
| DISSIS-FERRENTINO, ADRIENNE | Authorized Member | 7775 134TH ST, SEBASTIAN, FL 32958 |
| CASSIDENTE, DENA | Authorized Member | 10255 81ST STREET, VERO BEACH, FL 32968 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2021-03-29 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-23 |
| ANNUAL REPORT | 2023-04-24 |
| ANNUAL REPORT | 2022-01-28 |
| LC Amendment | 2021-03-29 |
| Florida Limited Liability | 2020-11-30 |
Date of last update: 15 Jan 2025
Sources: Florida Department of State
