| Entity Name: | JACKSONVILLE REHABILITATION AND NURSING CENTER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Company |
| Status: | Active |
| Date Filed: | 07 Jul 2022 (3 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 20 Nov 2024 (2 months ago) |
| Document Number: | M22000010508 |
| FEI/EIN Number | 88-3183961 |
| Address: | 2061 HYDE PARK RD, JACKSONVILLE, FL 32210 |
| Mail Address: | 2061 HYDE PARK RD, JACKSONVILLE, FL 32210 |
| ZIP code: | 32210 |
| County: | Duval |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033844485 | 2022-07-20 | 2024-10-07 | 2061 HYDE PARK RD, JACKSONVILLE, FL, 322103815, US | 2061 HYDE PARK RD, JACKSONVILLE, FL, 322103815, US | |||||||||||||||||||||
|
|||||||||||||||||||||||||
| Phone | +1 904-786-7331 |
| Fax | 9047864034 |
Authorized person
| Name | MOSHE KELMAN |
| Role | MEMBER |
| Phone | 9176131662 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | LICENSE |
| Number | 10800961 |
| State | FL |
| Name | Role |
|---|---|
| PLATINUM AGENT SERVICES LLC | Agent |
| Name | Role | Address |
|---|---|---|
| Brecher, Hal | Authorized Person | 6085 STRICKLAND AVENUE, BROOKLYN, NY 11234 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000030356 | WESTSIDE OAKS REHABILITATION & NURSING CENTER | ACTIVE | 2024-02-27 | 2029-12-31 | No data | 2061 HYDE PARK RD., JACKSONVILLE, FL, 32210 |
| G22000094702 | JACKSONVILLE REHABILITATION AND NURSING CENTER | ACTIVE | 2022-08-11 | 2027-12-31 | No data | 2061 HYDE PARK RD, JACKSONVILLE, FL, 32210 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC STMNT OF RA/RO CHG | 2024-11-20 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2024-11-20 | PLATINUM AGENT SERVICES LLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-11-20 | 155 OFFICE PLAZA DRIVE, TALLAHASSEE, FL 32301 | No data |
| REINSTATEMENT | 2023-10-13 | No data | No data |
| REVOKED FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| Name | Date |
|---|---|
| CORLCRACHG | 2024-11-20 |
| ANNUAL REPORT | 2024-02-05 |
| REINSTATEMENT | 2023-10-13 |
| Foreign Limited | 2022-07-07 |
Date of last update: 12 Jan 2025
Sources: Florida Department of State
