Entity Name: | HEARTLAND OF BOYNTON BEACH FL, LLC |
Jurisdiction: | FLORIDA |
Filing Type: | Foreign Limited Liability Co. |
Status: | Active |
Date Filed: | 27 Aug 2007 (17 years ago) |
Document Number: | M07000005232 |
FEI/EIN Number | 26-0623523 |
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 | |||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1962459727 | 2006-05-27 | 2022-01-23 | 333 N SUMMIT ST, TOLEDO, OH, 436042615, US | 3600 OLD BOYNTON RD, BOYNTON BEACH, FL, 334363912, US | |||||||||||||||||||||||||||||
|
Phone | +1 419-252-5500 |
Fax | 8773859446 |
Phone | +1 561-736-9992 |
Fax | 5613649527 |
Authorized person
Name | MR. MARTIN D ALLEN |
Role | DIRECTOR |
Phone | 4192525734 |
Taxonomy
Taxonomy Code | 314000000X - Skilled Nursing Facility |
License Number | SNF1210096 |
State | FL |
Is Primary | Yes |
Other Provider Identifiers
Issuer | MEDICAID |
Number | 032530900 |
State | FL |
Name | Role | Address |
---|---|---|
CT CORPORATION SYSTEM | Agent | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL, 33324 |
Name | Role | Address |
---|---|---|
Allen Martin | Manager | 100 Madison, Toledo, OH, 43604 |
Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
---|---|---|---|---|---|---|
G21000073345 | PROMEDICA SKILLED NURSING AND REHABILITATION (BOYNTON BEACH NORTH) | 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 | 2023-02-25 |
ANNUAL REPORT | 2022-04-06 |
ANNUAL REPORT | 2021-04-24 |
ANNUAL REPORT | 2020-05-11 |
ANNUAL REPORT | 2019-03-25 |
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