| Entity Name: | JACKSON PLAZA, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 10 Aug 2000 (25 years ago) |
| Document Number: | N00000005241 |
| FEI/EIN Number |
651040926
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4 Franklin Court, BRUNSWICK, FL, 08816, US |
| Mail Address: | 4 Franklin Court, BRUNSWICK, FL, 08816, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992890099 | 2006-10-04 | 2009-02-09 | 1861 NW 8TH AVE, MIAMI, FL, 331361115, US | 1861 NW 8TH AVE, MIAMI, FL, 331361115, US | |||||||||||||||||||||||||
|
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| Phone | +1 305-347-3380 |
| Fax | 3053473388 |
Authorized person
| Name | MS. TERRY G ESCOBAR |
| Role | ADMINISTRATOR |
| Phone | 3053473380 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF1255096 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 025372300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ROZSANSKY BEN | Director | 4 Franklin Court, East Brunswick, NJ, 08816 |
| WASSERMAN MARTY | Director | 4 Franklin Court, East Brunswick, NJ, 08816 |
| Fruhman Harry | Chief Executive Officer | 4 Franklin Court, East Brunswick, NJ, 08816 |
| Galbut Abraham A | Agent | 4770 Biscayne Blvd., Miami, FL, 33137 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000051113 | JACKSON PLAZA NURSING AND REHABILITATION CENTER | EXPIRED | 2012-06-04 | 2017-12-31 | - | 1800 N.E. 168 STREET, STE 200, NORTH MIAMI BEACH, FL, 33162 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-01-30 | 4 Franklin Court, BRUNSWICK, FL 08816 | - |
| CHANGE OF MAILING ADDRESS | 2023-01-30 | 4 Franklin Court, BRUNSWICK, FL 08816 | - |
| REGISTERED AGENT NAME CHANGED | 2020-10-06 | Galbut, Abraham A. | - |
| REGISTERED AGENT ADDRESS CHANGED | 2020-10-06 | 4770 Biscayne Blvd., Ste 1400, Miami, FL 33137 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-14 |
| ANNUAL REPORT | 2023-04-24 |
| ANNUAL REPORT | 2022-04-28 |
| AMENDED ANNUAL REPORT | 2021-09-27 |
| ANNUAL REPORT | 2021-04-29 |
| AMENDED ANNUAL REPORT | 2020-10-06 |
| ANNUAL REPORT | 2020-06-22 |
| ANNUAL REPORT | 2019-04-25 |
| ANNUAL REPORT | 2018-05-01 |
| ANNUAL REPORT | 2017-04-05 |
Date of last update: 01 Mar 2025
Sources: Florida Department of State
