| Entity Name: | TENDER LOVING CARE HEALTH CARE SERVICES OF BROWARD, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 12 May 2004 (21 years ago) |
| Date of dissolution: | 07 Dec 2022 (2 years ago) |
| Last Event: | WITHDRAWAL |
| Event Date Filed: | 07 Dec 2022 (2 years ago) |
| Document Number: | M04000001808 |
| FEI/EIN Number | 20-1031990 |
| Address: | 3854 American Way, Suite A, BATON ROUGE, LA 70816 |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639118987 | 2006-06-05 | 2009-12-18 | 5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA, 708166038, US | 3323 W. COMMERCIAL BOULEVARD, SUITE 100, FT. LAUDERDALE, FL, 333093456, US | |||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 225-292-2031 |
| Fax | 2252959678 |
| Phone | +1 954-486-5506 |
| Fax | 9547395129 |
Authorized person
| Name | MR. WILLIAM F BORNE |
| Role | CEO |
| Phone | 2252922031 |
Taxonomy
| Taxonomy Code | 251B00000X - Case Management Agency |
| License Number | 21128096 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | 21128096 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 687522000 |
| State | FL |
| Issuer | MEDICAID |
| Number | 651112100 |
| State | FL |
| Issuer | BCBS |
| Number | J93 |
| State | FL |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| TLC HEALTH CARE SERVICES,L.L.C. | Managing Member | 3854 American Way, Suite A BATON ROUGE, LA 70816 |
| Name | Role | Address |
|---|---|---|
| Gerard, Chris | President | 3854 American Way, Suite A BATON ROUGE, LA 70816 |
| Name | Role | Address |
|---|---|---|
| Griffin, Jennifer Guckert | Secretary | 3854 American Way, Suite A BATON ROUGE, LA 70816 |
| Name | Role | Address |
|---|---|---|
| Ginn, Scott G. | Vice President | 3854 American Way, Suite A BATON ROUGE, LA 70816 |
| Name | Role | Address |
|---|---|---|
| Ginn, Scott G. | Treasurer | 3854 American Way, Suite A BATON ROUGE, LA 70816 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| WITHDRAWAL | 2022-12-07 | No data | No data |
| LC STMNT OF RA/RO CHG | 2021-02-10 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-02-10 | 1201 HAYS ST, TALLAHASSEE, FL 32301 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-08-11 | 3854 American Way, Suite A, BATON ROUGE, LA 70816 | No data |
| Name | Date |
|---|---|
| WITHDRAWAL | 2022-12-07 |
| ANNUAL REPORT | 2022-05-02 |
| ANNUAL REPORT | 2021-04-30 |
| CORLCRACHG | 2021-02-10 |
| ANNUAL REPORT | 2020-04-03 |
| ANNUAL REPORT | 2019-04-10 |
| ANNUAL REPORT | 2018-04-02 |
| ANNUAL REPORT | 2017-04-10 |
| AMENDED ANNUAL REPORT | 2016-08-11 |
| ANNUAL REPORT | 2016-03-31 |
Date of last update: 29 Jan 2025
Sources: Florida Department of State
