| Entity Name: | HOSPICE OF THE PALM COAST, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Not For Profit Corporation |
| Status: | Inactive |
| Date Filed: | 24 Oct 2003 (21 years ago) |
| Date of dissolution: | 28 Oct 2009 (15 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 28 Oct 2009 (15 years ago) |
| Document Number: | N03000009293 |
| FEI/EIN Number | 20-0384141 |
| Address: | 149 S. RIDGEWOOD AVE, SUITE 400, DAYTONA BEACH, FL 32114 |
| Mail Address: | 149 S. RIDGEWOOD AVE, SUITE 400, DAYTONA BEACH, FL 32114 |
| ZIP code: | 32114 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912932948 | 2006-07-11 | 2009-08-25 | 717 N HARWOOD ST, SUITE 1500, DALLAS, TX, 752016519, US | 6161 BLUE LAGOON DRIVE, SUITE 170, MIAMI, FL, 331262045, US | |||||||||||||||||||||||||||||
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| Phone | +1 214-922-9711 |
| Fax | 2149229752 |
| Phone | +1 786-388-1400 |
| Fax | 7863881401 |
Authorized person
| Name | MR. RODNEY DIRK ALLISON |
| Role | SR VP & CFO |
| Phone | 2149229711 |
Taxonomy
| Taxonomy Code | 251G00000X - Community Based Hospice Care Agency |
| License Number | 50370970 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 150019800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 1200 S. PINE ISLAND ROAD, PLANTATION, FL 33324 |
| Name | Role | Address |
|---|---|---|
| LEFTON, ROBERT | President | 717 N HARWOOD, STE 1500, DALLAS, TX 75201 |
| Name | Role | Address |
|---|---|---|
| LEFTON, ROBERT | Chief Executive Officer | 717 N HARWOOD, STE 1500, DALLAS, TX 75201 |
| Name | Role | Address |
|---|---|---|
| ALLISON, R D | SVPC | 717 N HARWOOD, DALLAS, TX 75201 |
| Name | Role | Address |
|---|---|---|
| BICKHAM, BRAD | VPGC | 717 N HARWOOD, STE 1500, DALLAS, TX 75201 |
| Name | Role | Address |
|---|---|---|
| FLYNN, GREG | Vice President | 717 N HARWOOD, STE 1500, DALLAS, TX 75201 |
| Name | Role | Address |
|---|---|---|
| FLYNN, GREG | Controller | 717 N HARWOOD, STE 1500, DALLAS, TX 75201 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2009-10-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-03-21 | 149 S. RIDGEWOOD AVE, SUITE 400, DAYTONA BEACH, FL 32114 | No data |
| CHANGE OF MAILING ADDRESS | 2006-03-21 | 149 S. RIDGEWOOD AVE, SUITE 400, DAYTONA BEACH, FL 32114 | No data |
| REGISTERED AGENT NAME CHANGED | 2005-08-09 | CT CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-08-09 | 1200 S. PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| Name | Date |
|---|---|
| Voluntary Dissolution | 2009-10-28 |
| ANNUAL REPORT | 2009-04-24 |
| ANNUAL REPORT | 2008-09-09 |
| ANNUAL REPORT | 2007-05-09 |
| ANNUAL REPORT | 2006-03-21 |
| Reg. Agent Change | 2005-08-09 |
| ANNUAL REPORT | 2005-02-01 |
| ANNUAL REPORT | 2004-03-12 |
| Domestic Non-Profit | 2003-10-24 |
Date of last update: 05 Jan 2025
Sources: Florida Department of State
