| Entity Name: | HEARTLAND OF BOYNTON BEACH FL, 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: | 27 Aug 2007 (18 years ago) |
| Document Number: | M07000005232 |
| FEI/EIN Number |
26-0623523
Federal Employer Identification (FEI) Number assigned by the IRS. |
| 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 | |||||||||||||||||||||||||||||
|
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| 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 |
|---|---|---|
| Allen Martin | Manager | 100 Madison, Toledo, OH, 43604 |
| CT CORPORATION SYSTEM | Agent | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL, 33324 |
| 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 | - | 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 | - |
| CHANGE OF MAILING ADDRESS | 2024-05-01 | 100 Madison, Toledo, OH 43604 | - |
| 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 |
| Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 345862817 | 0418800 | 2022-03-29 | 3600 OLD BOYNTON, BOYNTON BEACH, FL, 33436 | |||||||||||||||||||||||||||||||||||||||||||||||
|
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| Type | Referral |
| Activity Nr | 1762542 |
| Health | Yes |
Violation Items
| Citation ID | 01001 |
| Citaton Type | Other |
| Standard Cited | 19040029 B04 |
| Issuance Date | 2022-09-15 |
| Abatement Due Date | 2023-06-12 |
| Current Penalty | 880.5 |
| Initial Penalty | 1761.0 |
| Contest Date | 2022-10-04 |
| Final Order | 2023-06-01 |
| Nr Instances | 1 |
| Nr Exposed | 15 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1904.29(b)(4): A form with equivalent information to OSHA's 301, Injury and Illness Incident Report, was not used by the employer to document each recordable injury and illness entered on the OSHA 300 Log: On or about March 29, 2022, at worksite located at 3600 Old Boynton, BOYNTON BEACH, FL 33436, an accident investigation report used as a form equivalent to the OSHA 301 lacked incident information such as, but not limited to, employee's address and sex; employee's date of birth and hire; name of physician treating employee, and nature of work done by employee just before the incident. |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
