| Entity Name: | ROYAL OAK NURSING CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 20 Sep 2000 (24 years ago) |
| Document Number: | M00000001944 |
| FEI/EIN Number | 621832435 |
| Address: | ROYAL OAK NURSING CENTER, 37300 ROYAL OAK LANE, DADE CITY, FL, 33525 |
| Mail Address: | 37300 Royal Oak Lane, Dade City, FL, 33525, US |
| ZIP code: | 33525 |
| County: | Pasco |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588660922 | 2005-06-21 | 2012-04-04 | 37300 ROYAL OAK LN, DADE CITY, FL, 335255230, US | 37300 ROYAL OAK LN, DADE CITY, FL, 335255230, US | |||||||||||||||||||||||||
|
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| Phone | +1 352-567-3122 |
| Fax | 3525672250 |
Authorized person
| Name | MRS. ANITA E HOWARD |
| Role | ADMINISTRATOR |
| Phone | 3525673122 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF14840962 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 022857500 |
| State | FL |
| Name | Role |
|---|---|
| NRAI SERVICES, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| Fisher Scott | Secretary | 7056 W GULF TO LAKE HWY, CRYSTAL RIVER, FL, 34429 |
| Name | Role | Address |
|---|---|---|
| Shatz Jim | President | 7056 West Gulf to Lake Highway, Crystal River, FL, 34429 |
| Name | Role | Address |
|---|---|---|
| Jackson Brian | Manager | 7056 West Gulf to Lake Highway, Crystal River, FL, 34429 |
| White Josh | Manager | 7056 West Gulf to Lake Highway, Crystal River, FL, 34429 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000092901 | ROYAL OAK NURSING CENTER | ACTIVE | 2017-08-22 | 2027-12-31 | No data | 37300 ROYAL OAK LANE, DADE CITY, FL, 33525 |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
