| Entity Name: | ATLANTIC SHORES HOSPITAL, 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: | 07 Dec 2005 (19 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 30 Jan 2017 (8 years ago) |
| Document Number: | M05000006740 |
| FEI/EIN Number |
203788069
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4545 NORTH FEDERAL HIGHWAY, FORT LAUDERDALE, FL, 33308, US |
| Mail Address: | 367 S. GULPH RD., KING OF PRUSSIA, PA, 19406, US |
| ZIP code: | 33308 |
| County: | Broward |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427002070 | 2006-05-19 | 2016-04-05 | 4545 NORTH FEDERAL HIGHWAY, FT LAUDERDALE, FL, 33068, US | 4545 NORTH FEDERAL HIGHWAY, FT LAUDERDALE, FL, 33068, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 954-771-2711 |
| Fax | 9544939998 |
Authorized person
| Name | STEVE FILLTON |
| Role | SR VP CFO |
| Phone | 6107683300 |
Taxonomy
| Taxonomy Code | 283Q00000X - Psychiatric Hospital |
| License Number | 4045 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 010358600 |
| State | FL |
| Issuer | MEDICAID |
| Number | 015005400 |
| State | FL |
| Name | Role |
|---|---|
| PREMIER BEHAVIORAL SOLUTIONS, INC. | Managing Member |
| CORPORATION SERVICE COMPANY | Agent |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC STMNT OF RA/RO CHG | 2017-01-30 | - | - |
| REGISTERED AGENT NAME CHANGED | 2017-01-30 | CORPORATION SERVICE COMPANY | - |
| REGISTERED AGENT ADDRESS CHANGED | 2017-01-30 | 1201 HAYS STREET, TALLAHASSEE, FL 32301 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2012-07-18 | 4545 NORTH FEDERAL HIGHWAY, FORT LAUDERDALE, FL 33308 | - |
| CHANGE OF MAILING ADDRESS | 2011-02-08 | 4545 NORTH FEDERAL HIGHWAY, FORT LAUDERDALE, FL 33308 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-26 |
| ANNUAL REPORT | 2023-04-05 |
| ANNUAL REPORT | 2022-04-19 |
| ANNUAL REPORT | 2021-04-16 |
| ANNUAL REPORT | 2020-04-03 |
| ANNUAL REPORT | 2019-04-12 |
| ANNUAL REPORT | 2018-04-03 |
| ANNUAL REPORT | 2017-04-05 |
| CORLCRACHG | 2017-01-30 |
| ANNUAL REPORT | 2016-03-01 |
Date of last update: 01 Mar 2025
Sources: Florida Department of State
