| Entity Name: | RAY OF GRACE HEALTHCARE SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 10 Aug 2021 (4 years ago) |
| Document Number: | L21000360047 |
| FEI/EIN Number | 88-0821213 |
| Address: | 9821 SW 3RD STREET, PEMBROKE PINES, FL 33025 |
| Mail Address: | 9821 SW 3RD STREET, PEMBROKE PINES, FL 33025 |
| ZIP code: | 33025 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891542759 | 2024-04-30 | 2024-09-06 | 9821 SW 3RD ST, PEMBROKE PINES, FL, 330251064, US | 9821 SW 3RD ST, PEMBROKE PINES, FL, 330251064, US | |||||||||||||||||||||||||
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| Phone | +1 786-208-2229 |
Authorized person
| Name | MRS. MARVA DANIEL-CLEOPHAT |
| Role | CEO |
| Phone | 7862082229 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | No |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DANIEL-CLEOPHAT, MARVA, MRS. | Agent | 9821 SW 3RD STREET, PEMBROKE PINES, FL 33025 |
| Name | Role | Address |
|---|---|---|
| CLEOPHAT, REGINALD | Manager | 9821 SW 3RD STREET, PEMBROKE PINES, FL 33025 UN |
| ORELUS, JEFFERSON, MR. | Manager | 6925 NW 173RD DRIVE, HIALEAH, FL 33015 |
| DANIEL, MARJORIE, MS. | Manager | 3501 SW 52ND AVE APT 107, MIRAMAR, FL 33023 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-04 |
| ANNUAL REPORT | 2023-04-17 |
| ANNUAL REPORT | 2022-02-24 |
| Florida Limited Liability | 2021-08-10 |
Date of last update: 13 Feb 2025
Sources: Florida Department of State
