| Entity Name: | HEARTLAND-PROSPERITY OAKS OF PALM BEACH GARDENS FL, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 27 Aug 2007 (17 years ago) |
| Document Number: | M07000005221 |
| FEI/EIN Number | 26-0623909 |
| 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 | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639126816 | 2006-05-31 | 2022-01-25 | 333 N SUMMIT ST, TOLEDO, OH, 436042615, US | 11375 PROSPERITY FARMS RD, PALM BEACH GARDENS, FL, 334103442, US | |||||||||||||||||||||||||||||
|
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| Phone | +1 419-252-5500 |
| Fax | 8773859446 |
| Phone | +1 561-626-9702 |
| Fax | 5616268581 |
Authorized person
| Name | MR. MARTIN D ALLEN |
| Role | DIRECTOR |
| Phone | 4192525734 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF1212096 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 032534100 |
| State | FL |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| Allen Martin | Manager | 100 Madison, Toledo, OH, 43604 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000073348 | PROMEDICA SKILLED NURSING AND REHABILITATION (PROSPERITY OAKS) | ACTIVE | 2021-06-01 | 2026-12-31 | No data | 333 N SUMMIT ST, 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 | 2023-02-27 |
| ANNUAL REPORT | 2022-04-05 |
| ANNUAL REPORT | 2021-04-24 |
| ANNUAL REPORT | 2020-05-14 |
| ANNUAL REPORT | 2019-03-23 |
| ANNUAL REPORT | 2018-04-06 |
| 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
