| Entity Name: | INDIGO CENTER FOR SENIOR LIVING, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 20 Aug 2021 (3 years ago) |
| Branch of: | INDIGO CENTER FOR SENIOR LIVING, LLC, NEW YORK (Company Number 6039309) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 14 Dec 2023 (a year ago) |
| Document Number: | M21000010975 |
| FEI/EIN Number | 00-0000000 |
| Address: | 1800 ROCKAWAY AVE, SUITE 200, HEWLETT, NY, 11557, US |
| Mail Address: | 1800 ROCKAWAY AVE, SUITE 200, HEWLETT, NY, 11557, US |
| Place of Formation: | NEW YORK |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043950801 | 2022-03-30 | 2022-09-15 | 113 W CHIPOLA AVE, DELAND, FL, 327207512, US | 113 W CHIPOLA AVE, DELAND, FL, 327207512, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 386-738-2700 |
| Fax | 3868229296 |
Authorized person
| Name | MORDECHAI WEISZ |
| Role | CEO |
| Phone | 3476314068 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | LICENSURE |
| Number | AL7143 |
| State | FL |
| Issuer | MEDICAID |
| Number | 113963100 |
| State | FL |
| Name | Role |
|---|---|
| RIVERSIDE FILINGS LLC | Agent |
| Name | Role | Address |
|---|---|---|
| IKE AKIKO | Manager | 1800 ROCKAWAY AVE, SUITE 200, HEWLETT, NY, 11557 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000112133 | WOODLAND TOWERS | ACTIVE | 2021-08-30 | 2026-12-31 | No data | 1800 ROCKAWAY, SUITE 200, HEWLETT, NY, 11557 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2023-12-14 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-12-14 | 155 OFFICE PLAZA DRIVE, 1ST FLOOR, TALLAHASSEE, FL 32301 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-12-14 | RIVERSIDE FILINGS LLC | No data |
| REVOKED FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REINSTATEMENT | 2022-11-07 | No data | No data |
| REVOKED FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| LC AMENDMENT | 2021-08-30 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-18 |
| REINSTATEMENT | 2023-12-14 |
| REINSTATEMENT | 2022-11-07 |
| LC Amendment | 2021-08-30 |
| Foreign Limited | 2021-08-20 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
