| Entity Name: | OSPREY NURSING AND REHABILITATION, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 14 Sep 2012 (12 years ago) |
| Document Number: | M12000005194 |
| FEI/EIN Number | 46-1564762 |
| Mail Address: | 1040 CROWN POINTE PKWY STE 600, ATLANTA, GA, 30338, US |
| Address: | 1104 NORTH MAIN STREET, BUSHNELL, FL, 33513, US |
| ZIP code: | 33513 |
| County: | Sumter |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1841536984 | 2012-12-18 | 2023-11-27 | 1104 N MAIN ST, BUSHNELL, FL, 335135045, US | 1104 N MAIN ST, BUSHNELL, FL, 335135045, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 352-568-8777 |
| Fax | 3525688780 |
Authorized person
| Name | KENNETH USSERY |
| Role | VP |
| Phone | 4075711550 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF130471001 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009267800 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role |
|---|---|
| CONSULATE MZHBS LEASEHOLDINGS, LLC | Member |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000121659 | OSPREY POINT NURSING CENTER | ACTIVE | 2012-12-17 | 2027-12-31 | No data | 1040 CROWN POINTE PARKWAY, SUITE 600, ATLANTA, GA, 30338 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2019-04-22 | 1104 NORTH MAIN STREET, BUSHNELL, FL 33513 | No data |
| CHANGE OF MAILING ADDRESS | 2019-04-22 | 1104 NORTH MAIN STREET, BUSHNELL, FL 33513 | No data |
| REGISTERED AGENT NAME CHANGED | 2013-04-16 | CORPORATION SERVICE COMPANY | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-04-16 | 1201 HAYS STREET, TALLAHASSEE, FL 32301-2525 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-04-22 |
| ANNUAL REPORT | 2021-04-21 |
| ANNUAL REPORT | 2020-04-20 |
| ANNUAL REPORT | 2019-04-22 |
| ANNUAL REPORT | 2018-04-25 |
| ANNUAL REPORT | 2017-04-19 |
| ANNUAL REPORT | 2016-04-27 |
| AMENDED ANNUAL REPORT | 2015-04-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
