| Entity Name: | HEARTLAND OF JACKSONVILLE FL, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 27 Aug 2007 (17 years ago) |
| Document Number: | M07000005202 |
| FEI/EIN Number | 26-0623590 |
| Address: | 100 Madison, Toledo, OH, 43604, US |
| Mail Address: | 100 Madison, Toledo, OH, 43604, US |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881641454 | 2006-05-28 | 2017-06-16 | 333 N SUMMIT ST, TOLEDO, OH, 436042615, US | 8495 NORMANDY BLVD, JACKSONVILLE, FL, 322216701, US | |||||||||||||||||||||||||||||
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| Phone | +1 419-252-5500 |
| Fax | 8773859446 |
| Phone | +1 904-783-3794 |
| Fax | 9046939137 |
Authorized person
| Name | MR. MARTIN D ALLEN |
| Role | DIRECTOR |
| Phone | 4192525734 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF1207095 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 032523600 |
| State | FL |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| Allen Martin | Manager | 100 Madison, Toledo, OH, 43604 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-05-01 | 100 Madison, Toledo, OH 43604 | No data |
| CHANGE OF MAILING ADDRESS | 2024-05-01 | 100 Madison, Toledo, OH 43604 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-01 |
| ANNUAL REPORT | 2023-02-25 |
| ANNUAL REPORT | 2022-04-04 |
| ANNUAL REPORT | 2021-04-22 |
| ANNUAL REPORT | 2020-05-11 |
| ANNUAL REPORT | 2019-03-25 |
| ANNUAL REPORT | 2018-04-07 |
| ANNUAL REPORT | 2017-04-18 |
| ANNUAL REPORT | 2016-04-09 |
| ANNUAL REPORT | 2015-04-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
