| Entity Name: | PRIME CARE ONE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 10 Mar 1997 (28 years ago) |
| Date of dissolution: | 25 Apr 2022 (3 years ago) |
| Last Event: | WITHDRAWAL |
| Event Date Filed: | 25 Apr 2022 (3 years ago) |
| Document Number: | M97000000117 |
| FEI/EIN Number |
352007426
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 450 E. 96th Street, Suite 500, INDIANAPOLIS, IN, 46240, US |
| Place of Formation: | INDIANA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447327648 | 2006-11-30 | 2014-12-30 | 1440 HIGHWAY A1A, VERO BEACH, FL, 329632310, US | 950 PINEBROOK RD, VENICE, FL, 342857147, US | |||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||
| Phone | +1 772-492-5002 |
| Fax | 7724925005 |
| Phone | +1 941-484-8801 |
| Fax | 9414843450 |
Authorized person
| Name | MR. THOMAS MITCHELL |
| Role | CFO, MGMT CO. |
| Phone | 7724925002 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL8813 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF130470962 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 021332200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HICKS JAY L | Managing Member | 450 E. 96th Street, INDIANAPOLIS, IN, 46240 |
| WHITMAN ARNOLD | Managing Member | 450 E. 96th Street, INDIANAPOLIS, IN, 46240 |
| DAVIES ROBERT N | Managing Member | 450 E. 96th Street, INDIANAPOLIS, IN, 46240 |
| PHILLIPPE THOMAS E | Manager | 450 E. 96th Street, INDIANAPOLIS, IN, 46240 |
| LEXISNEXIS DOCUMENT SOLUTIONS INC. | Agent | - |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000098380 | HARBORCHASE OF VENICE | EXPIRED | 2016-09-08 | 2021-12-31 | - | 950 PINEBROOK ROAD, VENICE, FL, 34285 |
| G16000098386 | HARBORCHASE OF NAPLES | EXPIRED | 2016-09-08 | 2021-12-31 | - | 7801 AIRPORT PULLING ROAD NORTH, NAPLES, FL, 34109 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| WITHDRAWAL | 2022-04-25 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2020-04-30 | 450 E. 96th Street, Suite 500, INDIANAPOLIS, IN 46240 | - |
| LC STMNT OF RA/RO CHG | 2017-07-10 | - | - |
| REGISTERED AGENT NAME CHANGED | 2003-07-25 | LEXISNEXIS DOCUMENT SOLUTIONS INC. | - |
| REINSTATEMENT | 2001-01-30 | - | - |
| REVOKED FOR ANNUAL REPORT | 2000-09-29 | - | - |
| REINSTATEMENT | 1999-11-30 | - | - |
| REVOKED FOR ANNUAL REPORT | 1999-10-14 | - | - |
| Name | Date |
|---|---|
| WITHDRAWAL | 2022-04-25 |
| ANNUAL REPORT | 2021-04-14 |
| ANNUAL REPORT | 2020-04-30 |
| ANNUAL REPORT | 2019-05-28 |
| ANNUAL REPORT | 2018-04-25 |
| CORLCRACHG | 2017-07-10 |
| ANNUAL REPORT | 2017-04-27 |
| ANNUAL REPORT | 2016-04-14 |
| ANNUAL REPORT | 2015-04-29 |
| ANNUAL REPORT | 2014-04-29 |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| - | IDV | VA248BO0168 | 2009-10-01 | - | - | |||||||||||||||||||||||
|
||||||||||||||||||||||||||||
| Obligated Amount | 100000.00 |
| Potential Award Amount | 300000.00 |
Description
| Title | NURSING HOME CONTRACT |
| NAICS Code | 623110: NURSING CARE FACILITIES |
| Product and Service Codes | Q402: NURSING HOME CARE CONTRACTS |
Recipient Details
| Recipient | PRIME CARE ONE LLC |
| UEI | C4RHBS21W5H4 |
| Recipient Address | 950 PINEBROOK RD, VENICE, SARASOTA, FLORIDA, 342857147, UNITED STATES |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
