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BLOUNTSTOWN REHABILITATION CENTER, LLC - Florida Company Profile

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Company Details

Entity Name: BLOUNTSTOWN REHABILITATION CENTER, LLC
Jurisdiction: FLORIDA
Filing Type: Foreign Limited Liability Co.
Status: Active
Date Filed: 28 Oct 2011 (14 years ago)
Last Event: LC NAME CHANGE
Event Date Filed: 03 Nov 2011 (14 years ago)
Document Number: M11000005409
FEI/EIN Number 383854685
Mail Address: 101 Sunnytown Road, Casselberry, FL, 32707, US
Address: 17884 NE Crozier Street, Blountstown, FL, 32424, US
ZIP code: 32424
City: Blountstown
County: Calhoun
Place of Formation: DELAWARE

Key Officers & Management

Role
Manager
Agent

Unique Entity ID

CAGE Code:
6QK25
UEI Expiration Date:
2020-02-13

Business Information

Doing Business As:
RIVER VALLEY REHABILITATION CENTER
Activation Date:
2019-02-13
Initial Registration Date:
2012-04-18

Commercial and government entity program

CAGE number:
6QK25
Status:
Obsolete
Type:
Non-Manufacturer
CAGE Update Date:
2024-02-14
CAGE Expiration:
2024-02-13

Contact Information

POC:
DONALD K. MELTON

National Provider Identifier

NPI Number:
1396021077

Authorized Person:

Name:
MR. R. MARK CRONQUIST
Role:
MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
314000000X - Skilled Nursing Facility
Is Primary:
No
Selected Taxonomy:
314000000X - Skilled Nursing Facility
Is Primary:
Yes

Contacts:

Fax:
4045742105
Fax:
8506749384

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G12000010396 RIVER VALLEY REHABILITATION CENTER ACTIVE 2012-01-31 2027-12-31 - 17884 NE CROZIER STREET, BLOUNTSTOWN, FL, 32424

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2017-03-30 17884 NE Crozier Street, Blountstown, FL 32424 -
REGISTERED AGENT ADDRESS CHANGED 2015-07-07 115 North Calhoun St., Suite 4, Tallahassee, FL 32301 -
CHANGE OF MAILING ADDRESS 2014-01-10 17884 NE Crozier Street, Blountstown, FL 32424 -
LC NAME CHANGE 2011-11-03 BLOUNTSTOWN REHABILITATION CENTER, LLC -

Documents

Name Date
ANNUAL REPORT 2024-02-05
ANNUAL REPORT 2023-03-09
ANNUAL REPORT 2022-02-24
ANNUAL REPORT 2021-03-18
ANNUAL REPORT 2020-04-14
ANNUAL REPORT 2019-03-21
ANNUAL REPORT 2018-04-27
ANNUAL REPORT 2017-03-30
ANNUAL REPORT 2016-03-30
ANNUAL REPORT 2015-01-13

USAspending Awards / Contracts

Procurement Instrument Identifier:
36C24818N4758
Award Or Idv Flag:
AWARD
Award Type:
DELIVERY ORDER
Action Obligation:
250000.00
Base And Exercised Options Value:
250000.00
Base And All Options Value:
250000.00
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2018-08-01
Description:
NURSING HOME SERVICES
Naics Code:
623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product Or Service Code:
Q402: MEDICAL- NURSING HOME CARE CONTRACTS
Procurement Instrument Identifier:
VA24817J4073
Award Or Idv Flag:
AWARD
Award Type:
DELIVERY ORDER
Action Obligation:
250000.00
Base And Exercised Options Value:
250000.00
Base And All Options Value:
250000.00
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2017-08-01
Description:
IGF::OT::IGF FOR OTHER FUNCTIONS RIVER VALLEY REHABILITATION CENTER
Naics Code:
623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product Or Service Code:
Q402: MEDICAL- NURSING HOME CARE CONTRACTS
Procurement Instrument Identifier:
VA24817E4089
Award Or Idv Flag:
AWARD
Award Type:
DELIVERY ORDER
Action Obligation:
35406.59
Base And Exercised Options Value:
35406.59
Base And All Options Value:
35406.59
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2017-04-01
Description:
EXPRESS REPORT: IGF::OT::IGF CONTRACT NURSING HOME PROGRAM
Naics Code:
623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product Or Service Code:
Q402: MEDICAL- NURSING HOME CARE CONTRACTS

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Date of last update: 03 Aug 2025

Sources: Florida Department of State