| Entity Name: | BLOUNTSTOWN HEALTH AND REHABILITATION CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 22 Dec 2008 (16 years ago) |
| Date of dissolution: | 09 Nov 2009 (15 years ago) |
| Last Event: | LC WITHDRAWAL |
| Event Date Filed: | 09 Nov 2009 (15 years ago) |
| Document Number: | M08000005510 |
| Address: | 1978 8TH AVE NW, HICKORY, NC, 28601 |
| Mail Address: | 1978 8TH AVE NW, HICKORY, NC, 28601 |
| Place of Formation: | VIRGINIA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033360862 | 2008-10-10 | 2008-10-10 | PO BOX 3343, HICKORY, NC, 286033343, US | 16690 SW CHIPOLA RD, BLOUNTSTOWN, FL, 324241953, US | |||||||||||||||||||||||
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| Phone | +1 828-324-8898 |
| Fax | 8283229598 |
| Phone | +1 850-674-4311 |
| Fax | 8506743798 |
Authorized person
| Name | MR. STEVEN D WOMACK |
| Role | MANAGER |
| Phone | 8283248898 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF1652096 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BLOUNTSTOWN HEALTH AND REHAB 401K PLAN | 2023 | 873508681 | 2024-07-01 | BLOUNTSTOWN HEALTH AND REHABILITATION CENTER | 101 | |||||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-07-01 |
| Name of individual signing | ANGELA STIDAM |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2024-07-01 |
| Name of individual signing | ANGELA STIDAM |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| DOMINION HEALTH CARE OPERATOR, LLC | Manager | 1978 8TH AVE NW, HICKORY, NC, 28601 |
| CAPITOL CORPORATE SERVICES, INC. | Agent | - |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-08-01 | 1978 8TH AVE NW, HICKORY, NC 28601 | - |
| CHANGE OF MAILING ADDRESS | 2025-08-01 | 1978 8TH AVE NW, HICKORY, NC 28601 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2024-08-01 | 1978 8TH AVE NW, HICKORY, NC 28601 | - |
| CHANGE OF MAILING ADDRESS | 2024-08-01 | 1978 8TH AVE NW, HICKORY, NC 28601 | - |
| LC WITHDRAWAL | 2009-11-09 | - | - |
| REVOKED FOR ANNUAL REPORT | 2009-09-25 | - | - |
| Name | Date |
|---|---|
| LC Withdrawal | 2009-11-09 |
| Foreign Limited | 2008-12-22 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
