| Entity Name: | BISHOP GRADY VILLAS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 14 May 2003 (22 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 19 Oct 2005 (19 years ago) |
| Document Number: | N03000004091 |
| FEI/EIN Number | 593598427 |
| Address: | 401 BISHOP GRADY CT., ST. CLOUD, FL, 34769 |
| Mail Address: | 401 BISHOP GRADY CT., ST. CLOUD, FL, 34769 |
| ZIP code: | 34769 |
| County: | Osceola |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558545475 | 2007-12-27 | 2014-03-01 | 401 BISHOP GRADY CT, SAINT CLOUD, FL, 347691538, US | 401 BISHOP GRADY CT, SAINT CLOUD, FL, 347691538, US | |||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 407-892-6078 |
| Fax | 4078928081 |
Authorized person
| Name | MR. KEVIN CHARLES JOHNSON |
| Role | EXECUTIVE DIRECTOR |
| Phone | 4078926078 |
Taxonomy
| Taxonomy Code | 251C00000X - Developmentally Disabled Services Day Training Agency |
| Is Primary | No |
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL10398 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 347C00000X - Private Vehicle |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 692217196 |
| State | FL |
| Issuer | MEDICAID |
| Number | 692217198 |
| State | FL |
| Issuer | MEDICAID |
| Number | 142955800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Johnson Kevin CMr. | Agent | 401 BISHOP GRADY CT., ST. CLOUD, FL, 34769 |
| Name | Role | Address |
|---|---|---|
| Kane Maureen | Chairman | 401 BISHOP GRADY CT., ST. CLOUD, FL, 34769 |
| Name | Role | Address |
|---|---|---|
| Johnson Kevin C | Exec | 401 BISHOP GRADY CT., ST. CLOUD, FL, 34769 |
| Name | Role | Address |
|---|---|---|
| Volkerson Paul Deacon | Vice President | 401 BISHOP GRADY CT., ST. CLOUD, FL, 34769 |
| Name | Role | Address |
|---|---|---|
| Harrold Bryan | Treasurer | 401 BISHOP GRADY CT., ST. CLOUD, FL, 34769 |
| Name | Role | Address |
|---|---|---|
| Drow Jennifer | Director | 401 BISHOP GRADY CT., ST. CLOUD, FL, 34769 |
| Gonzlaez Miguel Rev. | Director | 401 BISHOP GRADY CT., ST. CLOUD, FL, 34769 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000030499 | BISHOP GRADY VILLAS | ACTIVE | 2022-03-03 | 2027-12-31 | No data | 401 BISHOP GRADY CT, ST. CLOUD, FL, 34769 |
| G21000052612 | MAGNIFY OF CENTRAL FLORIDA | ACTIVE | 2021-04-16 | 2026-12-31 | No data | 401 BISHOP GRADY CT., ST. CLOUD, FL, 34769 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2019-04-05 | Johnson, Kevin Charles, Mr. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-04-05 | 401 BISHOP GRADY CT., ST. CLOUD, FL 34769 | No data |
| CANCEL ADM DISS/REV | 2005-10-19 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2005-10-19 | 401 BISHOP GRADY CT., ST. CLOUD, FL 34769 | No data |
| CHANGE OF MAILING ADDRESS | 2005-10-19 | 401 BISHOP GRADY CT., ST. CLOUD, FL 34769 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2005-09-16 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-18 |
| ANNUAL REPORT | 2023-01-19 |
| AMENDED ANNUAL REPORT | 2022-06-29 |
| AMENDED ANNUAL REPORT | 2022-06-28 |
| ANNUAL REPORT | 2022-02-02 |
| ANNUAL REPORT | 2021-01-11 |
| ANNUAL REPORT | 2020-04-02 |
| ANNUAL REPORT | 2019-04-05 |
| ANNUAL REPORT | 2018-01-17 |
| ANNUAL REPORT | 2017-04-18 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
