| Entity Name: | SUNCREST OUTPATIENT REHAB SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 24 Jun 2008 (17 years ago) |
| Date of dissolution: | 03 Dec 2024 (2 months ago) |
| Last Event: | WITHDRAWAL |
| Event Date Filed: | 03 Dec 2024 (2 months ago) |
| Document Number: | M08000003008 |
| FEI/EIN Number | 26-1910553 |
| Address: | 901 HUGH WALLIS RD S, LAFAYETTE, LA 70508 |
| Place of Formation: | TENNESSEE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649438805 | 2008-05-23 | 2012-06-29 | 510 HOSPITAL DR, SUITE 150, MADISON, TN, 371155033, US | 1503 OAK ST, JACKSONVILLE, FL, 322043910, US | |||||||||||||||||||||||||||||||
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| Phone | +1 615-627-9267 |
| Fax | 6155770081 |
| Phone | +1 904-353-2019 |
| Fax | 9043537762 |
Authorized person
| Name | AMANDA MCFADDIN |
| Role | DIRECTOR OF LICENSING/ACCREDITATION |
| Phone | 6157122250 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PROVIDER NO. |
| Number | AS074 |
| State | FL |
| Issuer | STATE LICENSE NO |
| Number | HCC9132 |
| State | FL |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| Proffitt, list Joshua L. | Manager | 901 HUGH WALLIS RD S, LAFAYETTE, LA 70508 |
| LHC GROUP, INC. | Manager | No data |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000012274 | MEDERI CARETENDERS | ACTIVE | 2021-01-25 | 2026-12-31 | No data | 901 HUGH WALLIS ROAD SOUTH, LAFAYETTE, LA, 70508 |
| G14000113540 | SUNCREST REHAB SERVICES | EXPIRED | 2014-11-11 | 2019-12-31 | No data | 9510 ORMSBY STATION ROAD, SUITE 300, LOUISVILLE, KY, 40223 |
| G08338900281 | SUNCREST REHAB SERVICES | EXPIRED | 2008-12-03 | 2013-12-31 | No data | 608 HOSPITAL DR, MADISON, TN, 37115 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| WITHDRAWAL | 2024-12-03 | No data | No data |
| LC STMNT OF RA/RO CHG | 2023-11-16 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2023-11-16 | C T CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-11-16 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| LC AMENDMENT | 2019-02-04 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-02-04 | 901 HUGH WALLIS RD S, LAFAYETTE, LA 70508 | No data |
| Name | Date |
|---|---|
| WITHDRAWAL | 2024-12-03 |
| ANNUAL REPORT | 2024-04-25 |
| CORLCRACHG | 2023-11-16 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-04-24 |
| ANNUAL REPORT | 2021-04-28 |
| ANNUAL REPORT | 2020-04-14 |
| ANNUAL REPORT | 2019-05-01 |
| LC Amendment | 2019-02-04 |
| ANNUAL REPORT | 2018-04-25 |
Date of last update: 26 Jan 2025
Sources: Florida Department of State
