| Entity Name: | ADVENTIST CARE CENTERS - COURTLAND, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Not For Profit Corporation |
| Status: | Inactive |
| Date Filed: | 26 Oct 2006 (18 years ago) |
| Date of dissolution: | 07 Aug 2024 (6 months ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 07 Aug 2024 (6 months ago) |
| Document Number: | N06000011214 |
| FEI/EIN Number | 20-5774723 |
| Address: | 730 Courtland Street, ORLANDO, FL 32804 |
| Mail Address: | 730 Courtland Street, ORLANDO, FL 32804 |
| ZIP code: | 32804 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811902646 | 2006-07-30 | 2023-11-27 | 900 HOPE WAY, ALTAMONTE SPRINGS, FL, 327141502, US | 730 COURTLAND ST, ORLANDO, FL, 328041316, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 407-975-3000 |
| Fax | 4079753090 |
| Phone | +1 407-975-3800 |
| Fax | 4079753900 |
Authorized person
| Name | MR. DAVID RODMAN |
| Role | ASST SECRETARY |
| Phone | 4079753011 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF130471014 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 022464200 |
| State | FL |
| Issuer | MEDICAID |
| Number | 032043900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BROMME, JEFF | Agent | 900 HOPE WAY, ALTAMONTE SPRINGS, FL 32714 |
| Name | Role | Address |
|---|---|---|
| RATHBUN, PAUL | Assistant Secretary | 900 HOPE WAY, ALTAMONTE SPRINGS, FL 32714 |
| RODMAN, DAVID | Assistant Secretary | 485 N. Keller Road, Suite 250 Maitland, FL 32751 |
| Hinds, Nigel | Assistant Secretary | 485 N. Keller Road, Suite 250 Maitland, FL 32751 |
| Pettijohn, Kelly | Assistant Secretary | 900 Hope Way, Altamonte Springs, FL 32714 |
| Boyce, Keith | Assistant Secretary | 485 N. Keller Road Suite 250, Maitland, FL 32751 |
| Huffman, David | Assistant Secretary | 900 Hope Way, Altamonte Springs, FL 32751 |
| Vincent, Haney | Assistant Secretary | 900 Hope Way, Altamonte Springs, FL 32751 |
| Name | Role | Address |
|---|---|---|
| Addiscott, Lynn | Asst. Secretary | 900 Hope Way, Altamonte Springs, FL 32714 |
| Saunders, Michael | Asst. Secretary | 900 Hope Way, Altamonte Springs, FL 32714 |
| Name | Role | Address |
|---|---|---|
| Graff, Jeffrey | Assitant Secretary | 900 Hope Way, Altamonte Springs, FL 32714 |
| Name | Role | Address |
|---|---|---|
| Beaulieu, Timothy | Director | 10605 Boca Pointe Drive, Orlando, FL 32836 |
| Thompson, Michael | Director | 550 E. Rollins Street, Orlando, FL 32803 |
| Pettijohn, Kelly | Director | 900 Hope Way, Altamonte Springs, FL 32714 |
| Young, Anita | Director | 485 N. Keller Road, Suite 250 Maitland, FL 32751 |
| Boyce, Keith | Director | 485 N. Keller Road Suite 250, Maitland, FL 32751 |
| McDonald, Raymond Andrew | Director | 485 N. Keller Road Suite 250, Suite 250 Maitland, FL 32751 |
| Stiltz, Bryan | Director | 900 Hope Way, Altamnte Springs, FL 32751 |
| Name | Role | Address |
|---|---|---|
| Boyce, Keith | President | 485 N. Keller Road Suite 250, Maitland, FL 32751 |
| Name | Role | Address |
|---|---|---|
| Stiltz, Bryan | Chairman | 900 Hope Way, Altamnte Springs, FL 32751 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000104357 | ADVENTHEALTH CARE CENTER ORLANDO NORTH | ACTIVE | 2018-09-21 | 2028-12-31 | No data | 730 COURTLAND STREET, ORLANDO, FL, 32804 |
| G18000095461 | ADVENTHEALTH TRANSITIONAL CARE ORLANDO NORTH | EXPIRED | 2018-08-27 | 2023-12-31 | No data | 730 COURTLAND STREET, ORLANDO, FL, 32804 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2024-08-07 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-20 | 730 Courtland Street, ORLANDO, FL 32804 | No data |
| CHANGE OF MAILING ADDRESS | 2023-02-20 | 730 Courtland Street, ORLANDO, FL 32804 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-01-25 | 900 HOPE WAY, ALTAMONTE SPRINGS, FL 32714 | No data |
| REGISTERED AGENT NAME CHANGED | 2011-01-26 | BROMME, JEFF | No data |
| Name | Date |
|---|---|
| Voluntary Dissolution | 2024-08-07 |
| ANNUAL REPORT | 2024-04-29 |
| AMENDED ANNUAL REPORT | 2023-01-26 |
| ANNUAL REPORT | 2023-01-24 |
| ANNUAL REPORT | 2022-04-25 |
| ANNUAL REPORT | 2021-04-23 |
| ANNUAL REPORT | 2020-06-22 |
| ANNUAL REPORT | 2019-04-18 |
| AMENDED ANNUAL REPORT | 2018-12-13 |
| AMENDED ANNUAL REPORT | 2018-07-31 |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
