Menu
Search icon
  1. Home Page
    2. ›
  2. Counties
    3. ›
  3. Lee
    4. ›
  4. 33905
    5. ›
  5. SHALIMARE INC.

SHALIMARE INC.

Company Details

Entity Name: SHALIMARE INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active
Date Filed: 30 Jun 2004 (21 years ago)
Last Event: AMENDMENT
Event Date Filed: 12 Jun 2006 (19 years ago)
Document Number: N04000006506
FEI/EIN Number 201344455
Address: 613 CAROLINA AVENUE, FT MYERS, FL, 33905
Mail Address: 613 CAROLINA AVENUE, FT MYERS, FL, 33905
ZIP code: 33905
County: Lee
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1578760187 2007-06-27 2020-08-22 613 CAROLINA AVE, FORT MYERS, FL, 339054015, US 613 CAROLINA AVE, FORT MYERS, FL, 339054015, US

Contacts
Phone +1 239-839-4997
Fax 2396931121

Authorized person
Name MS. MARY ELLEN PROVENCHER
Role PRESIDENT OF SHALIMARE INC.
Phone 2398394997

Taxonomy
Taxonomy Code 385HR2060X - Child Intellectual and/or Developmental Disabilities Respite Care
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SHALIMARE, INC. SAFE HARBOR 401(K) PLAN 2023 201344455 2024-09-04 SHALIMARE, INC. 88
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 623000
Sponsor’s telephone number 2398394997
Plan sponsor’s address 613 CAROLINA AVENUE, FORT MYERS, FL, 33905

Signature of
Role Plan administrator
Date 2024-09-04
Name of individual signing SHARON JASKE
Valid signature Filed with authorized/valid electronic signature
SHALIMARE, INC. SAFE HARBOR 401(K) PLAN 2022 201344455 2023-08-17 SHALIMARE, INC. 99
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 623000
Sponsor’s telephone number 2398394997
Plan sponsor’s address 613 CAROLINA AVENUE, FORT MYERS, FL, 33905

Signature of
Role Plan administrator
Date 2023-08-17
Name of individual signing SHARON JASKE
Valid signature Filed with authorized/valid electronic signature
SHALIMARE, INC. SAFE HARBOR 401(K) PLAN 2021 201344455 2022-10-10 SHALIMARE, INC. 96
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 623000
Sponsor’s telephone number 2398394997
Plan sponsor’s address 613 CAROLINA AVENUE, FORT MYERS, FL, 33905

Signature of
Role Plan administrator
Date 2022-10-10
Name of individual signing SHARON JASKE
Valid signature Filed with authorized/valid electronic signature
SHALIMARE, INC. SAFE HARBOR 401(K) PLAN 2020 201344455 2021-07-30 SHALIMARE, INC. 87
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 623000
Sponsor’s telephone number 2398394997
Plan sponsor’s address 613 CAROLINA AVENUE, FORT MYERS, FL, 33905

Signature of
Role Plan administrator
Date 2021-07-30
Name of individual signing SHARON JASKE
Valid signature Filed with authorized/valid electronic signature
SHALIMARE, INC. SAFE HARBOR 401(K) PLAN 2019 201344455 2020-09-01 SHALIMARE, INC. 81
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 623000
Sponsor’s telephone number 2398394997
Plan sponsor’s address 613 CAROLINA AVENUE, FORT MYERS, FL, 33905

Signature of
Role Plan administrator
Date 2020-09-01
Name of individual signing MARY PROVENCHER
Valid signature Filed with authorized/valid electronic signature
SHALIMARE, INC. SAFE HARBOR 401(K) PLAN 2018 201344455 2019-09-26 SHALIMARE, INC. 75
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 623000
Sponsor’s telephone number 2398394997
Plan sponsor’s address 613 CAROLINA AVENUE, FORT MYERS, FL, 33905

Signature of
Role Plan administrator
Date 2019-09-26
Name of individual signing MARY PROVENCHER
Valid signature Filed with authorized/valid electronic signature
SHALIMARE, INC. SAFE HARBOR 401(K) PLAN 2017 201344455 2018-10-25 SHALIMARE, INC. 62
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 623000
Sponsor’s telephone number 2398394997
Plan sponsor’s address 613 CAROLINA AVENUE, FORT MYERS, FL, 33905

Signature of
Role Plan administrator
Date 2018-10-24
Name of individual signing MARY PROVENCHER
Valid signature Filed with authorized/valid electronic signature
SHALIMARE, INC. SAFE HARBOR 401(K) PLAN 2017 201344455 2018-10-02 SHALIMARE, INC. 62
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 623000
Sponsor’s telephone number 2398394997
Plan sponsor’s address 613 CAROLINA AVENUE, FORT MYERS, FL, 33905

Signature of
Role Plan administrator
Date 2018-10-02
Name of individual signing MARY PROVENCHER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
PROVENCHER MARY E Agent 613 CAROLINA AVE., FORT MYERS, FL, 33905

President

Name Role Address
PROVENCHER MARY E President 10257 BELCREST BLVD, FORT MYERS, FL, 33913

Secretary

Name Role Address
NATOLI DENISE Secretary 812 JEFFERSON AVE., FT MYERS, FL, 33905

Vice President

Name Role Address
Provencher Linda A Vice President 1939 S. Palmetto Ave., Flagler Beach, FL, 32136

Treasurer

Name Role Address
BLAND Gaynell D Treasurer 770 CAYCE LANE, FORT MYERS, FL, 33905

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2007-01-03 613 CAROLINA AVE., FORT MYERS, FL 33905 No data
AMENDMENT 2006-06-12 No data No data
CHANGE OF PRINCIPAL ADDRESS 2005-06-01 613 CAROLINA AVENUE, FT MYERS, FL 33905 No data
CHANGE OF MAILING ADDRESS 2005-06-01 613 CAROLINA AVENUE, FT MYERS, FL 33905 No data

Documents

Name Date
ANNUAL REPORT 2025-01-14
ANNUAL REPORT 2024-01-10
ANNUAL REPORT 2023-01-11
ANNUAL REPORT 2022-01-15
ANNUAL REPORT 2021-01-10
ANNUAL REPORT 2020-01-19
ANNUAL REPORT 2019-01-20
ANNUAL REPORT 2018-01-13
ANNUAL REPORT 2017-01-09
ANNUAL REPORT 2016-01-17

Related by officers

PROVENCHER MARY E

JEANIE HOLDINGS LLC 13631 LEARNING COURT, LLC 160 SCHNEIDER, LLC TICE LLC C.B.'S HOUSE OF SOUL FOOD INC. MAE'S PLACE, HOUSE OF SOUL FOOD INC. PANACHE HOLISTICS INC

Provencher Linda A

CHATTANOOGA HOLDINGS LLC PANACHE HOLISTICS INC

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

Privacy policy Policy
About us About us
Contacts Contact us

© 2025 flprofile.com, Part of Big Data Integrated