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GRAND CANYON GROUP HOME LLC - Florida Company Profile

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Company Details

Entity Name: GRAND CANYON GROUP HOME LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 30 Aug 2021 (4 years ago)
Document Number: L21000386851
FEI/EIN Number NOT APPLICABLE
Address: 949 GRAND CANYON DRIVE, VALRICO, FL, 33594, US
Mail Address: PO BOX 963, VALRICO, FL, 33595, US
ZIP code: 33594
City: Valrico
County: Hillsborough
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
- Agent -
SIMPSON CASSANDRA V Manager 210 S PARSONS AVE, BRANDON, FL, 33511

National Provider Identifier

NPI Number:
1477278232
Certification Date:
2022-10-04

Authorized Person:

Name:
CASSANDRA VIRGINIA SIMPSON
Role:
DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
251E00000X - Home Health Agency
Is Primary:
No
Selected Taxonomy:
251J00000X - Nursing Care Agency
Is Primary:
No
Selected Taxonomy:
261QD1600X - Developmental Disabilities Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QH0100X - Health Service Clinic/Center
Is Primary:
No
Selected Taxonomy:
385HR2060X - Child Intellectual and/or Developmental Disabilities Respite Care
Is Primary:
No

Contacts:

Fax:
8138621072

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2023-04-25 FOCUS 9 ENTERPRISES LLC -
REGISTERED AGENT ADDRESS CHANGED 2022-04-12 2728 ENTERPRISE RD, STE 200, ORANGE CITY, FL 32763 -

Documents

Name Date
ANNUAL REPORT 2024-04-25
ANNUAL REPORT 2023-04-25
ANNUAL REPORT 2022-04-12
Florida Limited Liability 2021-08-30

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Date of last update: 01 Aug 2025

Sources: Florida Department of State