| Entity Name: | JEREMIAH'S WALK HOME & HEALTH AGENCY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 May 2023 (2 years ago) |
| Document Number: | L23000212366 |
| FEI/EIN Number | 92-3805724 |
| Address: | 3757 LONGLEAF FOREST LANE, N/A, JACKSONVILLE, FL, 32210, US |
| Mail Address: | 3757 LONGLEAF FOREST LANE, N/A, JACKSONVILLE, FL, 32210, US |
| ZIP code: | 32210 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114744976 | 2024-09-23 | 2024-10-19 | 3757 LONGLEAF FOREST LN, JACKSONVILLE, FL, 322109100, US | 3757 LONGLEAF FOREST LN, JACKSONVILLE, FL, 322109100, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 904-413-8839 |
Authorized person
| Name | MRS. GAIL NELSON-LEWIS |
| Role | OWNER |
| Phone | 9044009864 |
Taxonomy
| Taxonomy Code | 251J00000X - Nursing Care Agency |
| Is Primary | No |
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| Is Primary | No |
| Taxonomy Code | 310400000X - Assisted Living Facility |
| Is Primary | No |
| Taxonomy Code | 311Z00000X - Custodial Care Facility |
| Is Primary | No |
| Taxonomy Code | 320600000X - Intellectual and/or Developmental Disabilities Residential Treatment Facility |
| Is Primary | Yes |
| Taxonomy Code | 347C00000X - Private Vehicle |
| Is Primary | No |
| Taxonomy Code | 372600000X - Adult Companion |
| Is Primary | No |
| Taxonomy Code | 385H00000X - Respite Care |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| NELSON-LEWIS GAIL D | Agent | 3757 LONGLEAF FOREST LANE, JACKSONVILLE, FL, 32210 |
| Name | Role | Address |
|---|---|---|
| NELSON-LEWIS GAIL D | Manager | 3757 LONGLEAF FOREST LANE, JACKSONVILLE, FL, 32210 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-07 |
| Florida Limited Liability | 2023-05-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
