| Entity Name: | PENSACOLA FACILITY OPERATIONS, 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: | 11 Jul 2006 (19 years ago) |
| Document Number: | M06000003824 |
| FEI/EIN Number |
205113943
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 850 CONCOURSE PKWY S STE 250, MAITLAND, FL, 32751, US |
| Mail Address: | 1040 CROWN POINTE PKWY,, STE 600, ATLANTA, GA, 30338-4741, US |
| ZIP code: | 32751 |
| County: | Orange |
| Place of Formation: | OHIO |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386667210 | 2006-07-25 | 2021-12-22 | 235 W AIRPORT BLVD, PENSACOLA, FL, 325052239, US | 235 W AIRPORT BLVD, PENSACOLA, FL, 325052239, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 850-857-5200 |
| Fax | 8504772235 |
Authorized person
| Name | KENNETH USSERY |
| Role | VP |
| Phone | 4075711550 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF130470965 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 008040500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LV CHC HOLDINGS I, LLC | Member | 850 CONCOURSE PKWY S STE 250, MAITLAND, FL, 32751 |
| CORPORATION SERVICE COMPANY | Agent | - |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000137200 | LIVING CENTER OF PENSACOLA | ACTIVE | 2021-10-12 | 2026-12-31 | - | 1040 CROWN POINTE PARKWAY, SUITE 600, ATLANTA, GA, 30338 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-28 | 850 CONCOURSE PKWY S STE 250, MAITLAND, FL 32751 | - |
| CHANGE OF MAILING ADDRESS | 2018-06-20 | 850 CONCOURSE PKWY S STE 250, MAITLAND, FL 32751 | - |
| REGISTERED AGENT NAME CHANGED | 2012-04-23 | CORPORATION SERVICE COMPANY | - |
| REGISTERED AGENT ADDRESS CHANGED | 2012-04-23 | 1201 HAYS STREET, TALLAHASSEE, FL 32301 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-26 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-04-21 |
| ANNUAL REPORT | 2020-04-20 |
| ANNUAL REPORT | 2019-04-21 |
| ANNUAL REPORT | 2018-04-25 |
| ANNUAL REPORT | 2017-04-19 |
| ANNUAL REPORT | 2016-04-27 |
| ANNUAL REPORT | 2015-04-16 |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DELIVERY ORDER | AWARD | VA25612J1902 | 2012-09-30 | 2012-09-30 | 2012-09-30 | |||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||
| Obligated Amount | 22994.04 |
| Current Award Amount | 22994.04 |
| Potential Award Amount | 22994.04 |
Description
| Title | CONTRACTOR TO PROVIDE NURSING HOME SERVICES TO VA BENEFICIARIES -MOD TO REPORT DOLLARS IN FPDS |
| NAICS Code | 623110: NURSING CARE FACILITIES |
| Product and Service Codes | Q402: MEDICAL- NURSING HOME CARE CONTRACTS |
Recipient Details
| Recipient | PENSACOLA FACILITY OPERATIONS, LLC |
| UEI | CLL8EYXZKNY5 |
| Recipient Address | 235 W AIRPORT BLVD, PENSACOLA, ESCAMBIA, FLORIDA, 325052239, UNITED STATES |
| Unique Award Key | CONT_IDV_VA25612A0031_3600 |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Description
| Title | CONTRACTOR TO PROVIDE NURSING HOME SERVICES TO VA BENEFICIARIES |
| NAICS Code | 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES) |
| Product and Service Codes | Q402: MEDICAL- NURSING HOME CARE CONTRACTS |
Recipient Details
| Recipient | PENSACOLA FACILITY OPERATIONS, LLC |
| UEI | CLL8EYXZKNY5 |
| Legacy DUNS | 808225853 |
| Recipient Address | 235 W AIRPORT BLVD, PENSACOLA, 325052239, UNITED STATES |
| Unique Award Key | CONT_AWD_V520P7009_3600_-NONE-_-NONE- |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Description
| Title | NURSING HOME SERVICES |
| NAICS Code | 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES) |
| Product and Service Codes | Q402: NURSING HOME CARE CONTRACTS |
Recipient Details
| Recipient | PENSACOLA FACILITY OPERATIONS, LLC |
| UEI | CLL8EYXZKNY5 |
| Legacy DUNS | 808225853 |
| Recipient Address | 235 W AIRPORT BLVD, PENSACOLA, 325052239, UNITED STATES |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
