| Entity Name: | ELDERBERRY HOME HEALTH SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 02 Jul 2021 (4 years ago) |
| Document Number: | L21000304982 |
| FEI/EIN Number | N/A |
| Address: | 721 US Highway 1, 201, North Palm Beach, FL 33408 |
| Mail Address: | 721 US Highway 1, 201, North Palm Beach, FL 33408 |
| ZIP code: | 33408 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730751793 | 2021-07-10 | 2022-08-22 | 2895 S FEDERAL HWY STE B5, DELRAY BEACH, FL, 334833289, US | 2905 S FEDERAL HWY STE C6, DELRAY BEACH, FL, 334833267, US | |||||||||||||||||||||||||||
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| Phone | +1 561-306-5383 |
| Phone | +1 561-283-9681 |
Authorized person
| Name | MR. CHAD CHITWOOD |
| Role | MANAGING PARTNER/OWNER |
| Phone | 5612839681 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 113558700 |
| State | FL |
| Issuer | MEDICAID |
| Number | 1 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CHITWOOD, CHAD | Agent | 721 US Highway 1, 201, North Palm Beach, FL 33408 |
| Name | Role | Address |
|---|---|---|
| CHITWOOD, CHAD | Manager | 2905 S FEDERAL HWY C-6, DELRAY BEACH 33483 UN |
| RICCA, DIANE | Manager | 2905 S FEDERAL HWY, C-6 DELRAY BEACH, FL 33483 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-04 | 721 US Highway 1, 201, North Palm Beach, FL 33408 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-04 | 721 US Highway 1, 201, North Palm Beach, FL 33408 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-04 | 721 US Highway 1, 201, North Palm Beach, FL 33408 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-04 |
| ANNUAL REPORT | 2023-02-16 |
| ANNUAL REPORT | 2022-01-26 |
| Florida Limited Liability | 2021-07-02 |
Date of last update: 14 Jan 2025
Sources: Florida Department of State
