| Entity Name: | OASIS REHABILITATION AND HEALTH SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 17 Feb 2023 (2 years ago) |
| Date of dissolution: | 27 Sep 2024 (4 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (4 months ago) |
| Document Number: | L23000088279 |
| Address: | 115 CASTLEMAIN CIRCLE, DAVENPORT, FL 33897 |
| Mail Address: | 115 CASTLEMAIN CIRCLE, DAVENPORT, FL 33897 |
| ZIP code: | 33897 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285367383 | 2022-07-06 | 2022-07-06 | 115 CASTLEMAIN CIR, DAVENPORT, FL, 338970522, US | 115 CASTLEMAIN CIR, DAVENPORT, FL, 338970522, US | |||||||||||||||||||||||||||||||
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| Phone | +1 352-474-8519 |
Authorized person
| Name | NATALIE SMALL JOHNSON |
| Role | OWNER |
| Phone | 3524748519 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | No |
| Taxonomy Code | 261QA0600X - Adult Day Care Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 343900000X - Non-emergency Medical Transport (VAN) |
| Is Primary | No |
| Taxonomy Code | 372600000X - Adult Companion |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 115 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BUTLER, ANDRE, CEO | Agent | 115 CASTEMAIN CIRCLE, DAVENPORT, FL 33897 |
| Name | Role | Address |
|---|---|---|
| SMALL JOHNSON, NATALIE, COO | Chief Operating Officer | 2320 WATERS TRAIL DR, CHARLOTTE, NC 28216 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2023-02-17 |
Date of last update: 10 Feb 2025
Sources: Florida Department of State
