Entity Name: | FORT WALTON REHABILITATION CENTER, LLC |
Jurisdiction: | FLORIDA |
Filing Type: | Foreign Limited Liability Company |
Status: | Active |
Date Filed: | 28 Oct 2011 (13 years ago) |
Document Number: | M11000005438 |
FEI/EIN Number | 37-1651002 |
Mail Address: | 101 Sunnytown Road, Suite 201, Casselberry, FL 32707 |
Address: | 1 LBJ SR Drive, Fort Walton Beach, FL 32547 |
ZIP code: | 32547 |
County: | Okaloosa |
Place of Formation: | DELAWARE |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1962788646 | 2011-10-26 | 2014-09-29 | 5887 GLENRIDGE DR, SUITE 150, ATLANTA, GA, 303285574, US | 1 L B J SR DR, FORT WALTON BEACH, FL, 325471163, US | |||||||||||||||||||||||||||||||||||
|
Phone | +1 404-574-2100 |
Fax | 4045742105 |
Phone | +1 850-863-2066 |
Fax | 8508639006 |
Authorized person
Name | MR. R. MARK CRONQUIST |
Role | MANAGER |
Phone | 4045742100 |
Taxonomy
Taxonomy Code | 314000000X - Skilled Nursing Facility |
State | FL |
Is Primary | No |
Taxonomy Code | 314000000X - Skilled Nursing Facility |
License Number | SNF11610951 |
State | FL |
Is Primary | Yes |
Other Provider Identifiers
Issuer | MEDICAID |
Number | 004488800 |
State | FL |
Name | Role |
---|---|
COGENCY GLOBAL INC. | Agent |
Name | Role |
---|---|
SOUTHERN HEALTHCARE MANAGEMENT, LLC | MANAGER |
Name | Role |
---|---|
SOUTHERN HEALTHCARE MANAGEMENT, LLC | manager |
Name | Role |
---|---|
SOUTHERN HEALTHCARE MANAGEMENT, LLC | managed) |
Event Type | Filed Date | Value | Description |
---|---|---|---|
CHANGE OF MAILING ADDRESS | 2019-03-21 | 1 LBJ SR Drive, Fort Walton Beach, FL 32547 | No data |
CHANGE OF PRINCIPAL ADDRESS | 2017-03-30 | 1 LBJ SR Drive, Fort Walton Beach, FL 32547 | No data |
REGISTERED AGENT ADDRESS CHANGED | 2015-07-07 | 115 North Calhoun St., Suite 4, Tallahassee, FL 32301 | No data |
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THE ESTATE OF ETHELEENE GALLOWAY GORDON, ETC. VS FORT WALTON REHABILITATION CENTER, LLC, ET AL. | SC2022-0962 | 2022-07-25 | Closed | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
Name | Estate of Etheleene Galloway Gordon |
Role | Petitioner |
Status | Active |
Representations | Mr. Michael K. Beck, Ms. Lisa M. Tanaka |
Name | Shervon Tanyika Thomas |
Role | Petitioner |
Status | Active |
Name | R. Mark Cronquist |
Role | Petitioner |
Status | Active |
Name | SOVEREIGN HEALTHCARE DISBURSEMENTS, LLC |
Role | Respondent |
Status | Active |
Name | MARUTI TRANSIT GROUP LLC |
Role | Respondent |
Status | Active |
Name | ERIC BRUN |
Role | Respondent |
Status | Active |
Name | SOVEREIGN HEALTHCARE HOLDINGS, LLC |
Role | Respondent |
Status | Active |
Name | Robert Callander |
Role | Respondent |
Status | Active |
Name | Okaloosa County Coordinated Transporation, Inc. |
Role | Respondent |
Status | Active |
Name | FORT WALTON REHABILITATION CENTER, LLC |
Role | Respondent |
Status | Active |
Representations | Thomas A. Valdez, Kimberly J. Lopater, Vilma Martinez |
Name | John O'Donnell Mangine |
Role | Respondent |
Status | Active |
Name | MARUTI FLEET & MGMT, LLC |
Role | Respondent |
Status | Active |
Name | SOUTHERN HEALTHCARE MANAGEMENT, LLC |
Role | Respondent |
Status | Active |
Name | Hon. Michael Alan Flowers |
Role | Judge/Judicial Officer |
Status | Active |
Name | Hon. J. D. Peacock |
Role | Lower Tribunal Clerk |
Status | Active |
Name | Hon. Kristina Samuels |
Role | Lower Tribunal Clerk |
Status | Active |
Docket Entries
Docket Date | 2022-11-04 |
Type | Disposition |
Subtype | Rev DY Lack Juris |
Description | DISP-REV DY LACK JURIS ~ This cause having heretofore been submitted to the Court on jurisdictional briefs and portions of the record deemed necessary to reflect jurisdiction under Article V, Section 3(b), Florida Constitution, and the Court having determined that it should decline to accept jurisdiction, it is ordered that the petition for review is denied.No motion for rehearing will be entertained by the Court. See Fla. R. App. P. 9.330(d)(2). |
View | View File |
Docket Date | 2022-11-03 |
Type | Event |
Subtype | Fee Paid Through Portal |
Description | Fee Paid Through Portal |
Docket Date | 2022-11-03 |
Type | Miscellaneous Document |
Subtype | Pay Case Filing Fee-300 |
Description | PAY CASE FILING FEE-300 |
On Behalf Of | Estate of Etheleene Galloway Gordon |
View | View File |
Docket Date | 2022-10-21 |
Type | Miscellaneous Document |
Subtype | Lower Tribunal Transmittal Cover Sheet (Amended) |
Description | LOWER TRIBUNAL TRANSMITTAL COVER SHEET AMD ~ To reflect fee status |
On Behalf Of | Hon. Kristina Samuels |
View | View File |
Docket Date | 2022-10-21 |
Type | Order |
Subtype | Filing Fee Due |
Description | ORDER-FILING FEE DUE ~ The jurisdiction of this Court was invoked by the filing of a Notice to Invoke Discretionary Jurisdiction in the lower tribunal; however, said notice was not accompanied by the $300.00 filing fee or an order of insolvency from the district court of appeal as required by Florida Rules of Appellate Procedure 9.110(b) and 9.120(b). The filing fee is due and payable at the time of filing the notice. Petitioner is allowed to and including November 21, 2022, in which to submit the filing fee, or an order of insolvency, or a proper motion for leave to proceed in forma pauperis that complies with sections 57.081 and 57.082, Florida Statutes. Failure to submit the filing fee or one of the above referenced documents to this Court could result in the imposition of sanctions, including dismissal of the notice.Please understand that once this case is dismissed, it is not subject to reinstatement. |
View | View File |
Docket Date | 2022-09-08 |
Type | Brief |
Subtype | Juris Answer |
Description | JURIS ANSWER BRIEF ~ Respondents' Jurisdictional Answer Brief |
On Behalf Of | Fort Walton Rehabilitation Center, LLC |
View | View File |
Docket Date | 2022-08-30 |
Type | Order |
Subtype | Extension of Time (Juris Brief) |
Description | ORDER-EXT OF TIME GR (JURIS BRIEF-RESPONDENT) ~ Respondent's motion for extension of time is granted and respondent is allowed to and including September 8, 2022, in which to serve the jurisdictional answer brief. Multiple extensions of time for the same filing are discouraged. Absent extenuating circumstances, subsequent requests may be denied. |
View | View File |
Docket Date | 2022-08-29 |
Type | Motion |
Subtype | Ext of Time (Juris Brief) |
Description | MOTION-EXT OF TIME (JURIS BRIEF) ~ Unopposed Motion for Extension of Time to File Respondents' Jurisdictional Answer Brief |
On Behalf Of | Fort Walton Rehabilitation Center, LLC |
View | View File |
Docket Date | 2022-07-29 |
Type | Brief |
Subtype | Appendix-Juris |
Description | APPENDIX-JURIS BRIEF ~ Petitioner's Appendix |
On Behalf Of | Estate of Etheleene Galloway Gordon |
View | View File |
Docket Date | 2022-07-26 |
Type | Letter-Case |
Subtype | Acknowledgment Letter-New Case |
Description | ACKNOWLEDGMENT LETTER-NEW CASE |
View | View File |
Docket Date | 2022-07-25 |
Type | Misc. Events |
Subtype | Fee Status |
Description | FP:Fee Paid Through Portal |
Docket Date | 2022-07-25 |
Type | Notice |
Subtype | Invoke Discretionary Jurisdiction |
Description | NOTICE-DISCRETIONARY JURIS (DIRECT CONFLICT) |
On Behalf Of | Estate of Etheleene Galloway Gordon |
View | View File |
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 | 2016-03-23 |
ANNUAL REPORT | 2015-01-13 |
Date of last update: 24 Jan 2025
Sources: Florida Department of State