| Entity Name: | ARC PROFESSIONAL SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 Dec 2022 (2 years ago) |
| Document Number: | L22000505837 |
| FEI/EIN Number | 92-1240345 |
| Address: | 650 ORANGE AVE, ST AUGUSTINE, FL, 32092, UN |
| Mail Address: | 52 TUSCAN WAY, STE 202 #233, ST AUGUSTINE, FL, 32092 |
| ZIP code: | 32092 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1275584963 | 2006-05-15 | 2015-08-25 | 14337 SW 119TH AVE, MIAMI, FL, 331866006, US | 14337 SW 119TH AVE, MIAMI, FL, 331866006, US | |||||||||||||||||||||||||
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| Phone | +1 305-463-5355 |
| Fax | 3057794395 |
Authorized person
| Name | MR. RIDEL CABALLERO |
| Role | PRESIDENT/ADMINISTRATOR |
| Phone | 3054635355 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | 215710952 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 650544900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DAVIS PRISCILLA Y | Agent | 650 ORANGE AVE, ST AUGUSTINE, FL, 32092 |
| Name | Role | Address |
|---|---|---|
| DAVIS PRISCILLA Y | Chief Executive Officer | 650 ORANGE AVE, ST AUGUSTINE, FL, 32092 |
| Name | Role | Address |
|---|---|---|
| Davis Christoper D | Chief Operating Officer | 52 TUSCAN WAY, ST AUGUSTINE, FL, 32092 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-05 |
| ANNUAL REPORT | 2023-03-01 |
| Florida Limited Liability | 2022-12-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
