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  5. BROOKS SKILLED NURSING FACILITY A, INC.

BROOKS SKILLED NURSING FACILITY A, INC. - Florida Company Profile

Company Details

Entity Name: BROOKS SKILLED NURSING FACILITY A, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 18 Mar 2010 (15 years ago)
Last Event: AMENDMENT
Event Date Filed: 23 May 2011 (14 years ago)
Document Number: N10000002821
FEI/EIN Number 272153586

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 3599 UNIVERSITY BLVD. S, JACKSONVILLE, FL, 32216
Mail Address: 3599 UNIVERSITY BLVD. S, JACKSONVILLE, FL, 32216
ZIP code: 32216
County: Duval
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1669831079 2016-02-12 2024-09-20 3599 UNIVERSITY BLVD S, ATTN: MANAGED CARE, JACKSONVILLE, FL, 322164252, US 6210 BEACH BLVD, JACKSONVILLE, FL, 32216, US

Contacts
Phone +1 904-345-7291
Fax 9043457284
Phone +1 904-345-8101
Fax 9043458108

Authorized person
Name KELLI CAMERON
Role DIRECTOR OF MANAGED CARE
Phone 9043457158

Taxonomy
Taxonomy Code 314000000X - Skilled Nursing Facility
License Number SNF1149095
State FL
Is Primary Yes

Key Officers & Management

Name Role Address
BAER DOUGLAS M Chairman 3599 UNIVERSITY BLVD. S, JACKSONVILLE, FL, 32216
BAER DOUGLAS M Director 3599 UNIVERSITY BLVD. S, JACKSONVILLE, FL, 32216
Serkin Howard C Director 3599 UNIVERSITY BLVD. S, JACKSONVILLE, FL, 32216
DERIENZO VICTOR Vice President 3599 UNIVERSITY BLVD. S, JACKSONVILLE, FL, 32216
Tabor J B Director 3599 UNIVERSITY BLVD. S, JACKSONVILLE, FL, 32216
URS AGENTS, LLC Agent -
Mann Eric Director 3599 UNIVERSITY BLVD. S, JACKSONVILLE, FL, 32216

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G16000020310 UNIVERSITY CROSSING ACTIVE 2016-02-25 2026-12-31 - 3599 UNIVERSITY BLVD., S, JACKSONVILLE, FL, 32216
G16000020308 UNIVERSITY CROSSING SKILLED NURSING ACTIVE 2016-02-25 2026-12-31 - 3599 UNIVERSITY BLVD S, JACKSONVILLE, FL, 32216
G16000020309 BROOKS UNIVERSITY CROSSING ACTIVE 2016-02-25 2026-12-31 - 3599 UNIVERSITY BLVD.S, JACKSONVILLE, FL, 32216
G13000027006 BARTRAM CROSSING ACTIVE 2013-03-19 2028-12-31 - 3599 UNIVERSITY BLVD., S, 3RD FLOOR FINANCE DEPT., JACKSONVILLE, FL, 32216
G13000010134 THE GREEN HOUSE RESIDENCES ACTIVE 2013-01-29 2028-12-31 - 3599 UNIVERSITY BLVD., S, 3RD FLOOR FINANCE DEPT., JACKSONVILLE, FL, 32216
G13000010140 BARTRAM SENIOR SERVICES EXPIRED 2013-01-29 2018-12-31 - 3599 UNIVERSITY BLVD., S, JACKSONVILLE, FL, 32216
G13000010118 BROOKS REHABILITATION AT BARTRAM PARK EXPIRED 2013-01-29 2018-12-31 - 3599 UNIVERSITY BLVD., S, JACKSONVILLE, FL, 32216
G13000010124 BARTRAM CROSSING SKILLED NURSING ACTIVE 2013-01-29 2028-12-31 - 3599 UNIVERSITY BLVD., S, 3RD FLOOR FINANCE DEPT., JACKSONVILLE, FL, 32216
G13000010128 BARTRAM LAKES ASSISTED LIVING ACTIVE 2013-01-29 2028-12-31 - 3599 UNIVERSITY BLVD., S, 3RD FLOOR FINANCE DEPT., JACKSONVILLE, FL, 32216
G10000044414 ST. JOHNS HEALTH CARE CENTER EXPIRED 2010-05-20 2015-12-31 - 189 SAN MARCO AVENUE, ST. AUGUSTINE, FL, 32084

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2020-08-19 URS AGENTS, LLC -
REGISTERED AGENT ADDRESS CHANGED 2020-08-19 3458 LAKESHORE DRIVE, TALLAHASSEE, FL 32312 -
AMENDMENT 2011-05-23 - -
AMENDMENT 2010-08-16 - -

Documents

Name Date
ANNUAL REPORT 2024-04-24
ANNUAL REPORT 2023-04-19
ANNUAL REPORT 2022-04-26
ANNUAL REPORT 2021-03-22
Reg. Agent Change 2020-08-19
AMENDED ANNUAL REPORT 2020-06-30
ANNUAL REPORT 2020-04-02
ANNUAL REPORT 2019-04-26
ANNUAL REPORT 2018-04-24
Reg. Agent Change 2018-02-07

USAspending Awards. Contracts

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
DELIVERY ORDER AWARD 36C24824N0636 2024-06-01 2025-05-31 2025-05-31
Unique Award Key CONT_AWD_36C24824N0636_3600_36C24821D0066_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 660000.00
Current Award Amount 660000.00
Potential Award Amount 660000.00

Description
Title EO14042 - NURSING HOME SERVICES
NAICS Code 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product and Service Codes Q402: NURSING HOME, LONG-TERM & ADULT DAY CARE SERVICES

Recipient Details
Recipient BROOKS SKILLED NURSING FACILITY A, INC.
UEI HU7PKF21KMQ2
Recipient Address UNITED STATES, 6209 BROOKS BARTRAM DR BLDG 100, JACKSONVILLE, DUVAL, FLORIDA, 322585602
- IDV 36C24821D0066 2021-06-01 - -
Unique Award Key CONT_IDV_36C24821D0066_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 0.00
Potential Award Amount 3300000.00

Description
Title EO14042 - NURSING HOME SERVICES
NAICS Code 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product and Service Codes Q402: NURSING HOME, LONG-TERM & ADULT DAY CARE SERVICES

Recipient Details
Recipient BROOKS SKILLED NURSING FACILITY A, INC.
UEI HU7PKF21KMQ2
Recipient Address UNITED STATES, 6209 BROOKS BARTRAM DR BLDG 100, JACKSONVILLE, DUVAL, FLORIDA, 322585602
- IDV VA24812A0041 2012-07-10 - -
Unique Award Key CONT_IDV_VA24812A0041_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title NURSING HOME VETERANS CARE
NAICS Code 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product and Service Codes Q401: MEDICAL- NURSING

Recipient Details
Recipient BROOKS SKILLED NURSING FACILITY A, INC.
UEI HU7PKF21KMQ2
Legacy DUNS 928057129
Recipient Address 189 SAN MARCO AVE, SAINT AUGUSTINE, 320842733, UNITED STATES

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
27-2153586 Corporation Unconditional Exemption 3599 UNIVERSITY BLVD S, JACKSONVILLE, FL, 32216-4252 2011-02
In Care of Name -
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Hospital or medical research organization 170(b)(1)(A)(iii)
Tax Period 2023-12
Asset 10,000,000 to 49,999,999
Income 10,000,000 to 49,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 11436161
Income Amount 33879014
Form 990 Revenue Amount 33879014
National Taxonomy of Exempt Entities Health Care: Nursing, Convalescent Facilities
Sort Name -

Publication 78 Data
Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Determination Letter
Final Letter(s) FinalLetter_27-2153586_BROOKSSKILLEDNURSINGFACILITYAINC_11022010_01.tif
FinalLetter_27-2153586_BROOKSSKILLEDNURSINGFACILITYAINC_11022010_02.tif

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name BROOKS SKILLED NURSING FACILITY A INC
EIN 27-2153586
Tax Period 202212
Filing Type E
Return Type 990
File View File
Organization Name BROOKS SKILLED NURSING FACILITY A INC
EIN 27-2153586
Tax Period 202112
Filing Type E
Return Type 990
File View File
Organization Name BROOKS SKILLED NURSING FACILITY A INC
EIN 27-2153586
Tax Period 202012
Filing Type E
Return Type 990
File View File
Organization Name BROOKS SKILLED NURSING FACILITY A INC
EIN 27-2153586
Tax Period 201912
Filing Type E
Return Type 990
File View File
Organization Name BROOKS SKILLED NURSING FACILITY A INC
EIN 27-2153586
Tax Period 201812
Filing Type E
Return Type 990
File View File
Organization Name BROOKS SKILLED NURSING FACILITY A INC
EIN 27-2153586
Tax Period 201812
Filing Type P
Return Type 990T
File View File
Organization Name BROOKS SKILLED NURSING FACILITY A INC
EIN 27-2153586
Tax Period 201712
Filing Type E
Return Type 990
File View File
Organization Name BROOKS SKILLED NURSING FACILITY A INC
EIN 27-2153586
Tax Period 201612
Filing Type E
Return Type 990
File View File
Organization Name BROOKS SKILLED NURSING FACILITY A INC
EIN 27-2153586
Tax Period 201512
Filing Type E
Return Type 990
File View File

Companies related by officers

BAER DOUGLAS M

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BROOKS SKILLED NURSING FACILITY HOLDINGS A, INC. - Active
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Serkin Howard C

BROOKS HALIFAX REHABILITATION SERVICES, LLC - Active
Florida Limited Liability Co. (2010 )
BROOKS SKILLED NURSING FACILITY HOLDINGS A, INC. - Active
Domestic Non-Profit (2010 )
GH MEDICAL SERVICES, INC. - Inactive
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BROOKS SKILLED NURSING FACILITY HOLDINGS B, INC. - Active
Domestic Non-Profit (2011 )
THE GENESIS HEALTH FOUNDATION, INC. - Active
Domestic Non-Profit (1982 )
BROOKS SKILLED NURSING, INC. - Active
Domestic Non-Profit (2009 )
BROOKS SUPPORT SERVICES, LLC - Active
Florida Limited Liability Co. (2011 )
BROOKS SKILLED NURSING MANAGEMENT, LLC - Inactive
Florida Limited Liability Co. (2010 - 2020)
GH PARTNERSHIP HOLDINGS PPA, INC. - Inactive
Domestic Profit (1991 - 2020)

DERIENZO VICTOR

BROOKS HALIFAX REHABILITATION SERVICES, LLC - Active
Florida Limited Liability Co. (2010 )
BROOKS SKILLED NURSING FACILITY HOLDINGS A, INC. - Active
Domestic Non-Profit (2010 )
GH MEDICAL SERVICES, INC. - Inactive
Domestic Profit (1987 - 2023)
BROOKS SKILLED NURSING FACILITY HOLDINGS B, INC. - Active
Domestic Non-Profit (2011 )
THE GENESIS HEALTH FOUNDATION, INC. - Active
Domestic Non-Profit (1982 )
BROOKS SKILLED NURSING, INC. - Active
Domestic Non-Profit (2009 )
BROOKS SUPPORT SERVICES, LLC - Active
Florida Limited Liability Co. (2011 )
GLOBAL NURSE AGENCY LLC - Active
Florida Limited Liability Co. (2021 )
GH HOLDINGS, INC.. - Inactive
Domestic Profit (1990 - 2023)

URS AGENTS, LLC

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Foreign Profit (2004 )
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Foreign Profit (2025 )
SCOUT AMERICAS LLC - Active
Foreign Limited Liability Co. (2025 )
VISOR PARTNERS, LLC - Active
Florida Limited Liability Co. (2018 )

Mann Eric

BROOKS HALIFAX REHABILITATION SERVICES, LLC - Active
Florida Limited Liability Co. (2010 )
BROOKS SKILLED NURSING FACILITY HOLDINGS A, INC. - Active
Domestic Non-Profit (2010 )
SUPERIOR COACH DETAILING II LLC - Active
Florida Limited Liability Co. (2018 )
GENESIS HEALTH DEVELOPMENT, INC. - Active
Domestic Non-Profit (1983 )
BROOKS SKILLED NURSING FACILITY HOLDINGS B, INC. - Active
Domestic Non-Profit (2011 )
BROOKS SKILLED NURSING, INC. - Active
Domestic Non-Profit (2009 )
BROOKS REHABILITATION CLINICAL RESEARCH CENTER, INC. - Active
Domestic Non-Profit (2011 )
TIMUQUANA COUNTRY CLUB - Active
Domestic Non-Profit (1970 )
JACKSONVILLE CIVIC COUNCIL, INC. - Active
Domestic Non-Profit (2000 )
SVC MANUFACTURING, INC. - Active
Foreign Profit (1999 )

Companies related by address

3599 UNIVERSITY BLVD. S, JACKSONVILLE, FL, 32216

BROOKS SKILLED NURSING FACILITY HOLDINGS A, INC. BROOKS SKILLED NURSING FACILITY HOLDINGS B, INC.

3599 UNIVERSITY BLVD. S, JACKSONVILLE, FL, 32216

BROOKS SKILLED NURSING FACILITY HOLDINGS A, INC. BROOKS SKILLED NURSING FACILITY HOLDINGS B, INC.

Date of last update: 01 Apr 2025

Sources: Florida Department of State

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