| Entity Name: | EMPATH HOSPICE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 19 Aug 2021 (3 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 26 Apr 2023 (2 years ago) |
| Document Number: | L21000373692 |
| FEI/EIN Number | 92-1999764 |
| Address: | 331 South Florida Avenue, Suite 201, Lakeland, FL 33801 |
| Mail Address: | 5771 ROOSEVELT BLVD., 610, CLEARWATER, FL 33760 |
| ZIP code: | 33801 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407555949 | 2023-02-23 | 2024-03-08 | 5771 ROOSEVELT BLVD, CLEARWATER, FL, 337603407, US | 331 S FLORIDA AVE STE 201, LAKELAND, FL, 338014626, US | |||||||||||||||||
|
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| Phone | +1 727-467-7423 |
| Phone | +1 863-329-2750 |
| Fax | 8633292751 |
Authorized person
| Name | SAIDA BOUHAMID |
| Role | CFO |
| Phone | 9415527599 |
Taxonomy
| Taxonomy Code | 251G00000X - Community Based Hospice Care Agency |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HENDRICKS, CHRISTY | Agent | 6310 CAPITAL DRIVE, LAKEWOOD RANCH, FL 34202 |
| Name | Role | Address |
|---|---|---|
| FLEECE, JONATHAN D | Chief Executive Officer | 6310 CAPITAL DRIVE, LAKEWOOD RANCH, FL 34202 |
| Name | Role | Address |
|---|---|---|
| FLEECE, JONATHAN D | PRESIDENT | 6310 CAPITAL DRIVE, LAKEWOOD RANCH, FL 34202 |
| Name | Role | Address |
|---|---|---|
| BOUHAMID, SAIDA | Chief Financial Officer | 6310 CAPITAL DRIVE, LAKEWOOD RANCH, FL 34202 |
| Name | Role | Address |
|---|---|---|
| HENDRICKS, CHRISTY | Chief Learning Officer | 6310 CAPITAL DRIVE., LAKEWOOD RANCH, FL 34202 |
| Name | Role | Address |
|---|---|---|
| CLAUSSEN, ANN | Director | 331 South Florida Avenue, Suite 201 Lakeland, FL 33801 |
| COMER, LINDA, Dr. | Director | 331 South Florida Avenue, Suite 201 Lakeland, FL 33801 |
| REDDOUT, BRENDA | Director | 331 South Florida Avenue, Suite 201 Lakeland, FL 33801 |
| FREDERICK, CHANDRA | Director | 331 South Florida Avenue, Suite 201 Lakeland, FL 33801 |
| LUSA, ROBERT | Director | 331 SOUTH FLORIDA AVENUE, SUITE 201 LAKELAND, FL 33801 |
| CARRASQUILLO-RIVERA, VALERIA | Director | 6310 CAPITAL DRIVE, LAKEWOOD RANCH, FL 34202 |
| Name | Role | Address |
|---|---|---|
| CLAUSSEN, ANN | Chair | 331 South Florida Avenue, Suite 201 Lakeland, FL 33801 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-26 | 6310 CAPITAL DRIVE, LAKEWOOD RANCH, FL 34202 | No data |
| REINSTATEMENT | 2023-04-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-26 | 331 South Florida Avenue, Suite 201, Lakeland, FL 33801 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-04-26 | HENDRICKS, CHRISTY | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-26 |
| AMENDED ANNUAL REPORT | 2023-10-24 |
| REINSTATEMENT | 2023-04-26 |
| Florida Limited Liability | 2021-08-19 |
Date of last update: 13 Jan 2025
Sources: Florida Department of State
