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CREEKSIDE REHAB OPCO, LLC - Florida Company Profile

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Company Details

Entity Name: CREEKSIDE REHAB OPCO, LLC
Jurisdiction: FLORIDA
Filing Type: Foreign Limited Liability Co.
Status: Active
Date Filed: 25 Jan 2023 (3 years ago)
Document Number: M23000001003
FEI/EIN Number 92-1700013
Mail Address: 10150 HIGHLAND MANOR DR #300, TAMPA, FL, 33610, US
Address: 511 Swift Rd., Sarasota, FL, 34321, US
Place of Formation: DELAWARE

Key Officers & Management

Name Role Address
Friedman Leo Auth 10150 HIGHLAND MANOR DR #300, TAMPA, FL, 33610
- Agent -
WOZNIAK DAWN M Auth 10150 HIGHLAND MANOR DR #300, TAMPA, FL, 33610

U.S. Small Business Administration Profile

Phone Number:
941-266-3027
E-mail Address:
john.richards@astonhealth.com
Contact Person:
JOHN RICHARDS
User ID:
P3256580
Trade Name:
CREEKSIDE HEALTH REHABILITATION CENTER

Unique Entity ID

Unique Entity ID:
FTKRNN5SM9B1
CAGE Code:
9V1F6
UEI Expiration Date:
2026-03-04

Business Information

Doing Business As:
CREEKSIDE HEALTH REHABILITATION CENTER
Activation Date:
2025-03-06
Initial Registration Date:
2024-03-20

National Provider Identifier

NPI Number:
1952016214
Certification Date:
2023-01-20
Link:
View on NPI website

Authorized Person:

Name:
TRICIA THACKER
Role:
AUTHORIZED OFFICIAL
Phone:
8135586608

Taxonomy:

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

Contacts:

Phone:
+1 941-921-7462

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G23000021052 CREEKSIDE HEALTH REHABILITATION CENTER ACTIVE 2023-02-14 2028-12-31 - 5511 SWIFT RD, SARASOTA, FL, 34321

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-12-12 511 Swift Rd., Sarasota, FL 34321 -

Documents

Name Date
AMENDED ANNUAL REPORT 2024-12-12
ANNUAL REPORT 2024-04-30
Foreign Limited 2023-01-25

USAspending Awards / Contracts

Procurement Instrument Identifier:
36C24824D0077
Link:
View Award on USAspending website
Award Or Idv Flag:
IDV
Action Obligation:
0.00
Base And All Options Value:
4000000.00
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2024-07-01
Description:
ESTIMATED NURSING HOME SERVICES
Naics Code:
623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product Or Service Code:
Q402: NURSING HOME, LONG-TERM & ADULT DAY CARE SERVICES
Procurement Instrument Identifier:
36C24824N0792
Link:
View Award on USAspending website
Award Or Idv Flag:
AWARD
Award Type:
DELIVERY ORDER
Action Obligation:
800000.00
Base And Exercised Options Value:
800000.00
Base And All Options Value:
800000.00
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2024-07-01
Description:
NURSING HOME SERVICES
Naics Code:
623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product Or Service Code:
Q402: NURSING HOME, LONG-TERM & ADULT DAY CARE SERVICES

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Date of last update: 02 Aug 2025

Sources: Florida Department of State

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