| Entity Name: | BAXTER'S ADULT LIVING FACILITY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 12 Mar 2009 (16 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 05 Aug 2011 (13 years ago) |
| Document Number: | N09000002521 |
| FEI/EIN Number | 26-4671607 |
| Address: | 1092 MAJORCA AVE, PORT ST LUCIE, FL, 34954 |
| Mail Address: | 1092 MAJORCA AVE, PORT ST LUCIE, FL, 34954 |
| ZIP code: | 34954 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104269026 | 2013-04-10 | 2013-04-10 | 1092 SW MAJORCA AVENUE, PORT ST LUCIE, FL, 34953, US | 1092 SW MAJORCA AVENUE, PORT ST LUCIE, FL, 34953, US | |||||||||||||||||||||||||
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| Phone | +1 772-871-7865 |
| Fax | 7728717988 |
Authorized person
| Name | YVONNE S FRELANI |
| Role | OWNER/ADMINISTRATOR |
| Phone | 7728717865 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | 11666 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 001599100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FRELANI YVONNE | Agent | 1092 SW MAJORCA AVE, PORT ST LUCIE, FL, 34953 |
| Name | Role | Address |
|---|---|---|
| FRELANI YVONNE | President | 1092 SW MAJORCA AVE, PORT ST LUCIE, FL, 34953 |
| Name | Role | Address |
|---|---|---|
| LOUISE JASMINE | Treasurer | 2435 LINCOLN ST, HOLLYWOOD, FL, 33020 |
| Name | Role | Address |
|---|---|---|
| HAWKINS LOYE | Director | 19601 W OAKMONT DR, HIALEAH, FL, 33015 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2013-04-11 | 1092 SW MAJORCA AVE, PORT ST LUCIE, FL 34953 | No data |
| REINSTATEMENT | 2011-08-05 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-02 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-01-14 |
| ANNUAL REPORT | 2021-01-27 |
| ANNUAL REPORT | 2020-01-31 |
| ANNUAL REPORT | 2019-01-31 |
| ANNUAL REPORT | 2018-02-20 |
| ANNUAL REPORT | 2017-02-06 |
| ANNUAL REPORT | 2016-03-15 |
| ANNUAL REPORT | 2015-02-11 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
