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RIDGECREST NURSING AND REHAB LLC - Florida Company Profile

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Company Details

Entity Name: RIDGECREST NURSING AND REHAB LLC
Jurisdiction: FLORIDA
Filing Type: Foreign Limited Liability Co.
Status: Active
Date Filed: 29 Mar 2022 (3 years ago)
Document Number: M22000004748
FEI/EIN Number 88-0878671
Address: 1200 NORTH STONE STREET, DELAND, FL, 32720, US
Mail Address: 1200 NORTH STONE STREET, DELAND, FL, 32720, US
ZIP code: 32720
City: Deland
County: Volusia
Place of Formation: DELAWARE

Key Officers & Management

Name Role Address
Baltzly Jeannette Auth 1200 NORTH STONE STREET, DELAND, FL, 32720
RIDGECREST NURSING AND REHAB HOLDCO LLC Managing Member 400 RELLA BLVD, MONTEBELLO, NY, 10901
- Agent -

U.S. Small Business Administration Profile

Phone Number:
E-mail Address:
Contact Person:
TANIA ABRAHAM
Ownership and Self-Certifications:
Self-Certified Small Disadvantaged Business
User ID:
P2939514
Trade Name:
RIDGECREST HEALTHCARE AND REHABILITATION CENTER

Commercial and government entity program

CAGE number:
9EZG6
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2025-06-24
CAGE Expiration:
2030-06-24
SAM Expiration:
2026-06-20

Contact Information

POC:
TANIA ABRAHAM

National Provider Identifier

NPI Number:
1033867478
Certification Date:
2022-03-15

Authorized Person:

Name:
MOSHE SCHEINER
Role:
AUTHORIZED OFFICIAL
Phone:

Taxonomy:

Selected Taxonomy:
314000000X - Skilled Nursing Facility
Is Primary:
Yes

Contacts:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G22000043813 RIDGECREST HEALTHCARE AND REHABILITATION CENTER ACTIVE 2022-04-06 2027-12-31 - 1200 NORTH STONE STREET, DELAND, FL, 32720

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2025-01-08 7064 NORTHWEST 49TH STREET, LAUDERHILL, FL 33319 -
REVOKED FOR ANNUAL REPORT 2024-09-27 - -

Documents

Name Date
ANNUAL REPORT 2024-02-01
ANNUAL REPORT 2023-03-22
Foreign Limited 2022-03-29

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Date of last update: 03 Aug 2025

Sources: Florida Department of State