| Entity Name: | SHAWN DAVIS HEALTHCARE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 01 Mar 2024 (a year ago) |
| Document Number: | L24000108135 |
| Address: | 7643 GATE PKWY, 104-9222, JACKSONVILLE, FL 32256 |
| Mail Address: | 7643 GATE PKWY, 104-9222, JACKSONVILLE, FL 32256 |
| ZIP code: | 32256 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457119356 | 2024-03-06 | 2024-03-06 | 7643 GATE PKWY STE 104-9222, JACKSONVILLE, FL, 322563092, US | 7643 GATE PKWY STE 104-9222, JACKSONVILLE, FL, 322563092, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 904-386-2771 |
| Fax | 9043395403 |
Authorized person
| Name | SHANTIAH J DAVIS |
| Role | CEO |
| Phone | 9043862771 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| Is Primary | No |
| Taxonomy Code | 343900000X - Non-emergency Medical Transport (VAN) |
| Is Primary | No |
| Taxonomy Code | 385H00000X - Respite Care |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| DAVIS, SHANTIAH J | Agent | 7643 GATE PKWY, 104-9222, JACKSONVILLE, FL 32256 |
| Name | Role | Address |
|---|---|---|
| DAVIS, SHANTIAH J | Manager | 7643 GATE PKWY STE 104-9222, JACKSONVILLE, FL 32256 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-03-01 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State
