| Entity Name: | CG MADISON LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
CG MADISON LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 28 Dec 2021 (3 years ago) |
| Last Event: | CONVERSION |
| Event Date Filed: | 28 Dec 2021 (3 years ago) |
| Document Number: | L21000533858 |
| FEI/EIN Number |
59-3483845
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 2123 CENTRE POINTE BOULEVARD, TALLAHASSEE, FL, 32308, US |
| Mail Address: | 2123 CENTRE POINTE BOULEVARD, TALLAHASSEE, FL, 32308, US |
| ZIP code: | 32308 |
| County: | Leon |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801897541 | 2005-08-03 | 2023-09-21 | 2123 CENTRE POINTE BLVD, TALLAHASSEE, FL, 323084930, US | 2481 W US 90, MADISON, FL, 323404306, US | |||||||||||||||||||||||||||
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| Phone | +1 850-386-2831 |
| Fax | 8503861552 |
| Phone | +1 850-973-4880 |
| Fax | 8509732667 |
Authorized person
| Name | MR. JOSEPH D. MITCHELL |
| Role | PRESIDENT |
| Phone | 8503862522 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 021346200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MITCHELL JOSEPH D | Manager | 2123 CENTRE POINTE BOULEVARD, TALLAHASSEE, FL, 32308 |
| DAVIS ALAN G | Manager | 2123 CENTRE POINTE BOULEVARD, TALLAHASSEE, FL, 32308 |
| HANEY MARK T | Agent | 1656 METROPOLITAN CIRCLE, TALLAHASSEE, FL, 32308 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000100451 | MADISON HEALTH AND REHABILITATION CENTER | ACTIVE | 2024-08-26 | 2029-12-31 | - | 2841 WEST US 90, MADISON, FL, 32340 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-08-01 | HANEY, MARK T | - |
| REGISTERED AGENT ADDRESS CHANGED | 2023-08-01 | 1656 METROPOLITAN CIRCLE, TALLAHASSEE, FL 32308 | - |
| CONVERSION | 2021-12-28 | - | CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS P97000102742. CONVERSION NUMBER 900000221849 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-11 |
| ANNUAL REPORT | 2024-02-20 |
| AMENDED ANNUAL REPORT | 2023-08-01 |
| ANNUAL REPORT | 2023-04-21 |
| ANNUAL REPORT | 2022-04-29 |
| Florida Limited Liability | 2021-12-28 |
Date of last update: 03 Mar 2025
Sources: Florida Department of State
