| Entity Name: | SEAGRASS PCB MC LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 Aug 2018 (7 years ago) |
| Document Number: | M18000007056 |
| FEI/EIN Number | 352629608 |
| Address: | 228 N PARK AVE, STE A, WINTER PARK, FL, 32789, US |
| Mail Address: | 228 N PARK AVE, STE A, WINTER PARK, FL, 32789, US |
| ZIP code: | 32789 |
| County: | Orange |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003374455 | 2019-03-05 | 2023-03-02 | 2528 BARRINGTON CIR STE 2, TALLAHASSEE, FL, 323083888, US | 401 N ALF COLEMAN RD, PANAMA CITY BEACH, FL, 324072567, US | |||||||||||||||||||||
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| Phone | +1 850-583-7990 |
| Phone | +1 850-249-0707 |
Authorized person
| Name | SETH WALKER |
| Role | CFO |
| Phone | 8505837990 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 101956100 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| BOURNE ROBERT A | Managing Member | 228 N PARK AVE, STE A, WINTER PARK, FL, 32789 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000137011 | THE LANDING OF PANAMA CITY BEACH | ACTIVE | 2022-11-03 | 2027-12-31 | No data | 2573 BARRINGTON CIRCLE, TALLAHASSEE, FL, 32308 |
| G18000085722 | SEAGRASS VILLAGE OF PANAMA CITY BEACH | EXPIRED | 2018-08-03 | 2023-12-31 | No data | 410 N. ALF COLEMAN ROAD, PANAMA CITY BEACH, FL, 32407 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-11 |
| ANNUAL REPORT | 2023-03-09 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-03-15 |
| ANNUAL REPORT | 2020-03-17 |
| ANNUAL REPORT | 2019-02-11 |
| Foreign Limited | 2018-08-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
