| Entity Name: | GOOD SAM'S ASSISTED LIVING RESIDENCE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 27 Jun 2016 (9 years ago) |
| Document Number: | M16000005173 |
| FEI/EIN Number | 81-3000969 |
| Address: | 1 PEBBLE WOOD LANE, PALM COAST, FL, 32164, US |
| Mail Address: | 1 PEBBLE WOOD LANE, PALM COAST, FL, 32164, US |
| ZIP code: | 32164 |
| County: | Flagler |
| Place of Formation: | NEVADA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538604764 | 2016-12-26 | 2016-12-26 | 1 PEBBLE WOOD LN, PALM COAST, FL, 321647491, US | 1 PEBBLE WOOD LN, PALM COAST, FL, 321647491, US | |||||||||||||||||
|
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| Phone | +1 386-447-8145 |
Authorized person
| Name | MRS. L. JUDITH FERMIN-OSTRIN |
| Role | ADMINISTRATOR |
| Phone | 5165246624 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | 10049 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FERMIN JACINTA C | Agent | 6 CRANDELL COURT, PALM COAST, FL, 32137 |
| Name | Role | Address |
|---|---|---|
| FERMIN JACINTA C | Manager | 1 PEBBLE WOOD LANE, PALM COAST, FL, 32164 |
| FERMIN-OSTRIN L. JUDITH | Manager | 1 PEBBLE WOOD LANE, PALM COAST, FL, 32164 |
| Name | Role | Address |
|---|---|---|
| FERMIN LEANDRO JR F | Member | 6 Crandell Ct, Palm Coast, FL, 32137 |
| OSTRIN STEVEN H | Member | 15 Pinnacle Place, BUNNELL, FL, 32110 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2017-04-27 | 1 PEBBLE WOOD LANE, PALM COAST, FL 32164 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-04-27 | 6 CRANDELL COURT, PALM COAST, FL 32137 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-08 |
| ANNUAL REPORT | 2023-02-23 |
| ANNUAL REPORT | 2022-02-12 |
| ANNUAL REPORT | 2021-02-22 |
| ANNUAL REPORT | 2020-04-06 |
| ANNUAL REPORT | 2019-07-08 |
| ANNUAL REPORT | 2018-03-12 |
| ANNUAL REPORT | 2017-04-27 |
| Foreign Limited | 2016-06-27 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
