| Entity Name: | INDIAN ROCKS ASSISTED LIVING, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| 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: | 21 Apr 2004 (21 years ago) |
| Date of dissolution: | 07 Apr 2017 (8 years ago) |
| Last Event: | VOLUNTARY DISS W/ NOTICE |
| Event Date Filed: | 07 Apr 2017 (8 years ago) |
| Document Number: | N04000004117 |
| FEI/EIN Number |
030548503
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 12685 ULMERTON ROAD, LARGO, FL, 33774 |
| Mail Address: | 12685 ULMERTON ROAD, LARGO, FL, 33774 |
| ZIP code: | 33774 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366865784 | 2014-01-22 | 2014-01-22 | 2050 E BAY DR, LARGO, FL, 337712321, US | 2050 E BAY DR, LARGO, FL, 337712321, US | |||||||||||||||||||||||
|
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| Phone | +1 727-559-7666 |
Authorized person
| Name | DAVE GERY |
| Role | ADMINISTRATOR |
| Phone | 7275997644 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL10811 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 142595100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HANNAN BOB | Director | 12685 ULMERTON ROAD, LARGO, FL, 33774 |
| RAYMOND HETTERICH | Director | 12685 Ulmerton Road, Largo, FL, 33774 |
| RAYMOND HETTERICH | Treasurer | 12685 Ulmerton Road, Largo, FL, 33774 |
| FERGUSON TIMOTHY A | Director | 12685 ULMERTON ROAD, LARGO, FL, 33774 |
| FERGUSON TIMOTHY A | President | 12685 ULMERTON ROAD, LARGO, FL, 33774 |
| Veltman Greg | Director | 12685 Ulmerton Road, Largo, FL, 33774 |
| FERGUSON TIMOTHY A | Agent | 12685 ULMERTON ROAD, LARGO, FL, 33774 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000117035 | HERON HOUSE INDIAN ROCKS | EXPIRED | 2013-12-02 | 2018-12-31 | - | 2050 EAST BAY DRIVE, LARGO, FL, 33771 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISS W/ NOTICE | 2017-04-07 | - | - |
| Name | Date |
|---|---|
| CORAPVDWN | 2017-04-07 |
| ANNUAL REPORT | 2016-03-31 |
| ANNUAL REPORT | 2015-01-28 |
| ANNUAL REPORT | 2014-03-20 |
| ANNUAL REPORT | 2013-04-18 |
| ANNUAL REPORT | 2012-03-20 |
| ANNUAL REPORT | 2011-02-17 |
| ANNUAL REPORT | 2010-04-29 |
| ANNUAL REPORT | 2009-04-14 |
| ANNUAL REPORT | 2008-04-30 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
