| Entity Name: | COASTAL CARE RESIDENCE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 15 Jun 2023 (2 years ago) |
| Document Number: | L23000289264 |
| FEI/EIN Number | 931884486 |
| Address: | 235 APOLLO BEACH BLVD, 182, APOLLO BEACH, FL, 33572, US |
| Mail Address: | 235 APOLLO BEACH BLVD, 182, APOLLO BEACH, FL, 33572, US |
| ZIP code: | 33572 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336927870 | 2023-09-18 | 2024-05-06 | 235 APOLLO BEACH BLVD # 182, APOLLO BEACH, FL, 335722251, US | 216 APOLLO BEACH BLVD, APOLLO BEACH, FL, 33572, US | |||||||||||||||||||
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| Phone | +1 727-417-1723 |
| Phone | +1 727-674-1800 |
Authorized person
| Name | CHEVELLE R JORDAN |
| Role | OWNER |
| Phone | 7276741800 |
Taxonomy
| Taxonomy Code | 251C00000X - Developmentally Disabled Services Day Training Agency |
| Is Primary | Yes |
| Taxonomy Code | 261QD1600X - Developmental Disabilities Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| JORDAN CHEVELLE R | Agent | 235 APOLLO BEACH BLVD, APOLLO BEACH, FL, 33572 |
| Name | Role | Address |
|---|---|---|
| JORDAN CHEVELLE R | Chief Executive Officer | 235 APOLLO BEACH BLVD #182, APOLLO BEACH, FL, 33572 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| Florida Limited Liability | 2023-06-15 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
