| Entity Name: | RWW SENIOR LIVING OUTPATIENT REHAB SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Company |
| Status: | Active |
| Date Filed: | 10 Jul 2024 (7 months ago) |
| Document Number: | M24000008757 |
| FEI/EIN Number | 99-3775482 |
| Address: | 805 N. WHITTINGTON PARKWAY, SUITE 400, LOUISVILLE, KY 40222 |
| Mail Address: | 805 N. WHITTINGTON PARKWAY, SUITE 400, LOUISVILLE, KY 40222 |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093553240 | 2024-07-19 | 2024-07-19 | 805 N WHITTINGTON PKWY STE 400, LOUISVILLE, KY, 402227102, US | 2430 COUNTY ROAD 21 W, ST JOHNS, FL, 32259, US | |||||||||||||
|
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| Phone | +1 904-717-7782 |
Authorized person
| Name | ANGIE MATTINGLY |
| Role | MGR PROVIDER ENROLLMENT |
| Phone | 5023942100 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | Yes |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| SHERRY PEMBERTON, MARGARET | Manager | 805 N. WHITTINGTON PARKWAY, SUITE 400, LOUISVILLE, KY 40222 |
| Name | Role | Address |
|---|---|---|
| BROWN, ALLISON L | Secretary | 805 N. WHITTINGTON PARKWAY, SUITE 400, LOUISVILLE, KY 40222 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000122120 | REHAB IN MOTION | ACTIVE | 2024-10-01 | 2029-12-31 | No data | 805 N WHITTINGTON PARKWAY, STE 400, LOUISVILLE, KY, 40222 |
| Name | Date |
|---|---|
| Foreign Limited | 2024-07-10 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State
