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MARION HOUSE REHABILITATION CENTER, LLC

Company Details

Entity Name: MARION HOUSE REHABILITATION CENTER, LLC
Jurisdiction: FLORIDA
Filing Type: Foreign Limited Liability Company
Status: Active
Date Filed: 26 Apr 2012 (13 years ago)
Document Number: M12000002333
FEI/EIN Number 90-0817988
Mail Address: 101 Sunnytown Road, Suite 201, Casselberry, FL 32707
Address: 3930 E. Silver Springs Blvd., Ocala, FL 34470
ZIP code: 34470
County: Marion
Place of Formation: DELAWARE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1801152137 2012-04-11 2014-09-29 5887 GLENRIDGE DR NE, SUITE 150, ATLANTA, GA, 303285574, US 3930 E SILVER SPRINGS BLVD, OCALA, FL, 344705086, US

Contacts

Phone +1 404-574-2100
Fax 4045742105
Phone +1 352-236-2626
Fax 3522360888

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 SNF13230961
State FL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 004861100
State FL

Agent

Name Role
COGENCY GLOBAL INC. Agent

MANAGER

Name Role
SOUTHERN HEALTHCARE MANAGEMENT, LLC MANAGER

manager

Name Role
SOUTHERN HEALTHCARE MANAGEMENT, LLC manager

managed)

Name Role
SOUTHERN HEALTHCARE MANAGEMENT, LLC managed)

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G12000045909 OCALA OAKS REHABILITATION CENTER ACTIVE 2012-05-17 2027-12-31 No data 3930 EAST SILVER SPRINGS BLVD., OCALA, FL, 34470

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2017-03-30 3930 E. Silver Springs Blvd., Ocala, FL 34470 No data
REGISTERED AGENT ADDRESS CHANGED 2015-07-07 115 North Calhoun St., Suite 4, Tallahassee, FL 32301 No data
CHANGE OF MAILING ADDRESS 2014-01-10 3930 E. Silver Springs Blvd., Ocala, FL 34470 No data

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 2015-01-09

Date of last update: 23 Jan 2025

Sources: Florida Department of State