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SOVEREIGN HEALTHCARE OF ATLANTIC SHORES, LLC - Florida Company Profile

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Company Details

Entity Name: SOVEREIGN HEALTHCARE OF ATLANTIC SHORES, LLC
Jurisdiction: FLORIDA
Filing Type: Foreign Limited Liability Co.
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 15 Jul 2003 (22 years ago)
Document Number: M03000002353
FEI/EIN Number 200184812

Federal Employer Identification (FEI) Number assigned by the IRS.

Mail Address: 101 Sunnytown Road, Casselberry, FL, 32707, US
Address: 4251 Stack Boulevard, Melbourne, FL, 32901, US
ZIP code: 32901
County: Brevard
Place of Formation: DELAWARE

Key Officers & Management

Name Role
SOUTHERN HEALTHCARE MANAGEMENT, LLC Manager
COGENCY GLOBAL INC. Agent

Commercial and government entity program

The The Commercial And Government Entity Code (CAGE) is assigned by the Department of Defense's Defense Logistics Agency (DLA) and represents your company's physical address for GSA's mailings, payments, and administrative records.

Note: A CAGE Code enables a company to contract with the U.S. government, allowing bid on government contracts and to receive government payments. Also for business this means that it's a Verified business entity and Has a validated physical address.

CAGE number:
3YWH9
Status:
Obsolete
Type:
Non-Manufacturer
CAGE Update Date:
2022-04-22
CAGE Expiration:
2022-04-21

Contact Information

POC:
DONALD K MELTON

National Provider Identifier

NPI Number:
1831186477

Authorized Person:

Name:
MR. R. MARK CRONQUIST
Role:
MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
314000000X - Skilled Nursing Facility
Is Primary:
Yes

Contacts:

Fax:
4045742105
Fax:
3219532002

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G09048900140 ATLANTIC SHORES NURSING AND REHAB CENTER ACTIVE 2009-02-17 2029-12-31 - 4251 STACK BOULEVARD, MELBOURNE, FL, 32901

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2017-03-30 4251 Stack Boulevard, Melbourne, FL 32901 -
REGISTERED AGENT ADDRESS CHANGED 2015-07-07 115 North Calhoun St., Suite 4, Tallahassee, FL 32301 -
CHANGE OF MAILING ADDRESS 2014-01-10 4251 Stack Boulevard, Melbourne, FL 32901 -

Documents

Name Date
ANNUAL REPORT 2024-02-05
ANNUAL REPORT 2023-03-09
ANNUAL REPORT 2022-02-24
ANNUAL REPORT 2021-03-18
ANNUAL REPORT 2020-04-14
ANNUAL REPORT 2019-03-21
ANNUAL REPORT 2018-04-27
ANNUAL REPORT 2017-03-30
ANNUAL REPORT 2016-03-30
ANNUAL REPORT 2015-01-13

USAspending Awards / Contracts

Procurement Instrument Identifier:
VA24816J2560
Award Or Idv Flag:
AWARD
Award Type:
DELIVERY ORDER
Action Obligation:
54307.44
Base And Exercised Options Value:
54307.44
Base And All Options Value:
54307.44
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2016-08-18
Description:
IGF::CT::IGF NURSING HOME SERVICES FOR ORLANDO VA PO: 675-Y61160
Naics Code:
623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product Or Service Code:
Q402: MEDICAL- NURSING HOME CARE CONTRACTS
Procurement Instrument Identifier:
VA24814A0015
Award Or Idv Flag:
IDV
Action Obligation:
0.00
Base And Exercised Options Value:
0.00
Base And All Options Value:
0.00
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2014-02-01
Description:
IGF::CT::IGF NURSING HOME SERVICES FOR ORLANDO VA 675C45013
Naics Code:
623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product Or Service Code:
Q402: MEDICAL- NURSING HOME CARE CONTRACTS
Procurement Instrument Identifier:
V673P5340FY08
Award Or Idv Flag:
AWARD
Award Type:
DO
Action Obligation:
297421.98
Base And Exercised Options Value:
297421.98
Base And All Options Value:
297421.98
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2007-10-01
Description:
COMMUNITY NURSING HOME EXPENDITURE - FY08
Naics Code:
623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product Or Service Code:
Q402: NURSING HOME CARE CONTRACTS

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Date of last update: 01 Jun 2025

Sources: Florida Department of State