Entity Name: | LONGEVITY AND WELLBEING, LLC |
Jurisdiction: | FLORIDA |
Filing Type: | Florida Limited Liability Co. |
Status: | Active |
Date Filed: | 06 Apr 2021 (4 years ago) |
Document Number: | L21000144137 |
FEI/EIN Number | 863180986 |
Address: | 7039 STIRLING RD, DAVIE, FL, 33314, US |
Mail Address: | 7039 STIRLING RD, DAVIE, FL, 33314, US |
ZIP code: | 33314 |
County: | Broward |
Place of Formation: | FLORIDA |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1114591237 | 2021-05-13 | 2021-05-19 | 10160 NW 6TH ST, PEMBROKE PINES, FL, 330263983, US | 10160 NW 6TH ST, PEMBROKE PINES, FL, 330263983, US | |||||||||||||||||||
|
Phone | +1 786-350-0576 |
Authorized person
Name | LISA SKIRVING |
Role | PRESIDENT |
Phone | 7863500576 |
Taxonomy
Taxonomy Code | 251B00000X - Case Management Agency |
Is Primary | Yes |
Other Provider Identifiers
Issuer | MEDICAID |
Number | 107978600 |
State | FL |
Name | Role | Address |
---|---|---|
LISA A.W. SKIRVING | Agent | 7039 STIRLING RD, DAVIE, FL, 33314 |
Name | Role | Address |
---|---|---|
LISA A.W. SKIRVING | Managing Member | 7039 STIRLING RD, DAVIE, FL, 33314 |
Event Type | Filed Date | Value | Description |
---|---|---|---|
CHANGE OF PRINCIPAL ADDRESS | 2022-02-19 | 7039 STIRLING RD, Suite 2304, DAVIE, FL 33314 | No data |
CHANGE OF MAILING ADDRESS | 2022-02-19 | 7039 STIRLING RD, Suite 2304, DAVIE, FL 33314 | No data |
REGISTERED AGENT ADDRESS CHANGED | 2022-02-19 | 7039 STIRLING RD, Suite 2304, DAVIE, FL 33314 | No data |
Name | Date |
---|---|
ANNUAL REPORT | 2024-02-08 |
ANNUAL REPORT | 2023-01-27 |
ANNUAL REPORT | 2022-02-19 |
Florida Limited Liability | 2021-04-06 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State