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  5. GOOD SAM'S ASSISTED LIVING RESIDENCE, LLC

GOOD SAM'S ASSISTED LIVING RESIDENCE, LLC - Florida Company Profile

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Company Details

Entity Name: GOOD SAM'S ASSISTED LIVING RESIDENCE, LLC
Jurisdiction: FLORIDA
Filing Type: Foreign Limited Liability Co.
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 27 Jun 2016 (9 years ago)
Document Number: M16000005173
FEI/EIN Number 81-3000969

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 1 PEBBLE WOOD LANE, PALM COAST, FL, 32164, US
Mail Address: 1 PEBBLE WOOD LANE, PALM COAST, FL, 32164, US
ZIP code: 32164
City: Palm Coast
County: Flagler
Place of Formation: NEVADA

Key Officers & Management

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
FERMIN LEANDRO JR F Member 6 Crandell Ct, Palm Coast, FL, 32137
OSTRIN STEVEN H Member 15 Pinnacle Place, BUNNELL, FL, 32110
FERMIN JACINTA C Agent 6 CRANDELL COURT, PALM COAST, FL, 32137

National Provider Identifier

NPI Number:
1538604764
Link:
View on NPI website

Authorized Person:

Name:
MRS. L. JUDITH FERMIN-OSTRIN
Role:
ADMINISTRATOR
Phone:
5165246624

Taxonomy:

Selected Taxonomy:
310400000X - Assisted Living Facility
Is Primary:
Yes

Contacts:

Phone:
+1 386-447-8145

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2017-04-27 1 PEBBLE WOOD LANE, PALM COAST, FL 32164 -
REGISTERED AGENT ADDRESS CHANGED 2017-04-27 6 CRANDELL COURT, PALM COAST, FL 32137 -

Documents

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

USAspending Awards / Financial Assistance

Date:
2021-12-07
Link:
View on USAspending
Awarding Agency Name:
Small Business Administration
Transaction Description:
AWARDTYPE: DIRECT PAYMENT FOR SPECIFIED USE ACTIVITIES TO BE PERFORMED: CONTINUE BUSINESS DELIVERABLES: ECONOMIC RELIEF TO SMALL BUSINESSES IMPACTED BY COVID-19. EXPECTED OUTCOMES: PROVIDE ECONOMIC RELIEF TO BUSINESSES THAT ARE CURRENTLY EXPERIENCING A TEMPORARY LOSS OF REVENUE. INTENDED BENEFICIARIES: SMALL BUSINESSES SUBRECIPIENT ACTIVITIES: NA
Obligated Amount:
10000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2021-11-29
Link:
View on USAspending
Awarding Agency Name:
Small Business Administration
Transaction Description:
AWARDTYPE: DIRECT LOANS ACTIVITIES TO BE PERFORMED: PROVIDE LOANS TO BUSINESSES IMPACTED BY THE COVID-19 PANDEMIC FOR UNINSURED OR OTHERWISE UNCOMPENSATED ECONOMIC INJURY. DELIVERABLES: LOANS EXPECTED OUTCOMES: EXPECTED OUTCOMES: ENABLE BUSINESSES TO FUND POST-DISASTER ORDINARY AND NECESSARY OPERATING EXPENSES UNTIL NORMAL OPERATIONS RESUME INTENDED BENEFICIARIES: SURVIVORS OF DISASTER SUBRECIPIENT ACTIVITIES: NA
Obligated Amount:
0.00
Face Value Of Loan:
182200.00
Total Face Value Of Loan:
182200.00
Date:
2021-03-18
Link:
View on USAspending
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
-5000.00
Total Face Value Of Loan:
10000.00
Date:
2020-05-03
Link:
View on USAspending
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
10000.00
Total Face Value Of Loan:
10000.00

Paycheck Protection Program

Jobs Reported:
3
Initial Approval Amount:
$10,000
Date Approved:
2020-05-01
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$10,000
Race:
Asian
Ethnicity:
Not Hispanic or Latino
Gender:
Female Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$10,071.67
Servicing Lender:
Newtek Small Business Finance, Inc.
Use of Proceeds:
Payroll: $10,000
Jobs Reported:
3
Initial Approval Amount:
$15,000
Date Approved:
2021-01-20
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$10,000
Race:
Unanswered
Ethnicity:
Not Hispanic or Latino
Gender:
Female Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$10,058.33
Servicing Lender:
Newtek Small Business Finance, Inc.
Use of Proceeds:
Payroll: $9,997
Utilities: $1

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Date of last update: 02 Jul 2025

Sources: Florida Department of State

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