| Entity Name: | MY EXTENDED FAMILY ASSISTED LIVING LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 10 Jun 2022 (3 years ago) |
| Document Number: | L22000266062 |
| FEI/EIN Number | 92-0809991 |
| Address: | 4420 ROBIN AVE, NAPLES, FL, 34104, US |
| Mail Address: | 4420 ROBIN AVE, NAPLES, FL, 34104, US |
| ZIP code: | 34104 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518668276 | 2023-03-10 | 2023-03-10 | 5426 TEXAS AVE, NAPLES, FL, 341137859, US | 5426 TEXAS AVE, NAPLES, FL, 341137859, US | |||||||||||||||||||||||||
|
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| Phone | +1 239-285-3990 |
Authorized person
| Name | MISS BONIA BAPTISTE |
| Role | ADMIN MANAGER |
| Phone | 2392853990 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 882736455 |
| State | FL |
| Issuer | UNITED HEALTHCARE |
| Number | 882736455 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BAPTISTE BONIA | Agent | 4420 ROBIN AVE, NAPLES, FL, 34104 |
| Name | Role | Address |
|---|---|---|
| BAPTISTE BONIA | Administrator | 4420 ROBIN AVE, NAPLES, FL, 34104 |
| Name | Role | Address |
|---|---|---|
| Baptiste Jean K | President | 5426 TEXAS AVE, Naples, FL, 34113 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-04-16 | 4420 ROBIN AVE, NAPLES, FL 34104 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-16 | 4420 ROBIN AVE, NAPLES, FL 34104 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-10 | 4420 ROBIN AVE, NAPLES, FL 34104 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-02-10 | BAPTISTE, BONIA | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-04-16 |
| ANNUAL REPORT | 2024-01-18 |
| ANNUAL REPORT | 2023-02-10 |
| Florida Limited Liability | 2022-06-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
