| Entity Name: | HQM OF SURREY PLACE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 12 Aug 2002 (23 years ago) |
| Date of dissolution: | 13 Jul 2009 (16 years ago) |
| Last Event: | LC WITHDRAWAL |
| Event Date Filed: | 13 Jul 2009 (16 years ago) |
| Document Number: | M02000002117 |
| FEI/EIN Number |
611420655
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Mail Address: | PO BOX 31809, PALM BEACH GARDENS, FL, 33420 |
| Address: | 2979 PGA BOULEVARD, PALM BEACH GARDENS, FL, 33410 |
| ZIP code: | 33410 |
| County: | Palm Beach |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366421836 | 2006-01-12 | 2009-02-24 | 110 LEE AVE SE, LIVE OAK, FL, 320649504, US | 110 LEE AVE SE, LIVE OAK, FL, 320649504, US | |||||||||||||||||||||||
|
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| Phone | +1 386-364-5961 |
Authorized person
| Name | MR. PAUL WALCZAK |
| Role | CEO |
| Phone | 5616270664 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF1540096 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 025710900 |
| State | FL |
| Name | Role |
|---|---|
| HOME QUALITY MANAGEMENT, INC. | Managing Member |
| CORPORATE CREATIONS NETWORK INC. | Agent |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC WITHDRAWAL | 2009-07-13 | - | - |
| CHANGE OF MAILING ADDRESS | 2008-03-31 | 2979 PGA BOULEVARD, PALM BEACH GARDENS, FL 33410 | - |
| REGISTERED AGENT NAME CHANGED | 2005-08-12 | CORPORATE CREATIONS NETWORK, INC. | - |
| REGISTERED AGENT ADDRESS CHANGED | 2005-08-12 | 11380 PROSPERITY FARMS ROAD #221E, PALM BEACH GARDENS, FL 33410 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2005-03-04 | 2979 PGA BOULEVARD, PALM BEACH GARDENS, FL 33410 | - |
| CANCEL ADM DISS/REV | 2005-03-04 | - | - |
| REVOKED FOR ANNUAL REPORT | 2004-10-01 | - | - |
| Name | Date |
|---|---|
| LC Withdrawal | 2009-07-13 |
| ANNUAL REPORT | 2008-03-31 |
| ANNUAL REPORT | 2007-04-30 |
| ANNUAL REPORT | 2006-04-28 |
| Reg. Agent Change | 2005-08-12 |
| REINSTATEMENT | 2005-03-04 |
| ANNUAL REPORT | 2003-02-18 |
| Foreign Limited | 2002-08-12 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
