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

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
County: Flagler
Place of Formation: NEVADA

National Provider Identifier

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

Contacts

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

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

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

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
9936617706 2020-05-01 0491 PPP 1 Pebble Wood Ln, Palm Coast, FL, 32164-7491
Loan Status Date 2021-03-20
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 10000
Loan Approval Amount (current) 10000
Undisbursed Amount 0
Franchise Name -
Lender Location ID 317954
Servicing Lender Name Newtek Small Business Finance, Inc.
Servicing Lender Address 1981 Marcus Avenue, LAKE SUCCESS, NY, 11042
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Palm Coast, FLAGLER, FL, 32164-7491
Project Congressional District FL-06
Number of Employees 3
NAICS code 623990
Borrower Race Asian
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 317954
Originating Lender Name Newtek Small Business Finance, Inc.
Originating Lender Address LAKE SUCCESS, NY
Gender Female Owned
Veteran Non-Veteran
Forgiveness Amount 10071.67
Forgiveness Paid Date 2021-02-23
2365148304 2021-01-20 0491 PPS 1 Pebble Wood Ln, Palm Coast, FL, 32164-7491
Loan Status Date 2021-11-11
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 15000
Loan Approval Amount (current) 10000
Undisbursed Amount 0
Franchise Name -
Lender Location ID 317954
Servicing Lender Name Newtek Small Business Finance, Inc.
Servicing Lender Address 1981 Marcus Avenue, LAKE SUCCESS, NY, 11042
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Palm Coast, FLAGLER, FL, 32164-7491
Project Congressional District FL-06
Number of Employees 3
NAICS code 623312
Borrower Race Unanswered
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 317954
Originating Lender Name Newtek Small Business Finance, Inc.
Originating Lender Address LAKE SUCCESS, NY
Gender Female Owned
Veteran Non-Veteran
Forgiveness Amount 10058.33
Forgiveness Paid Date 2021-10-20

Date of last update: 01 Apr 2025

Sources: Florida Department of State