| Entity Name: | INDEPENDENT LIVING WITH CARE ALF, 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: | 11 Jun 2014 (11 years ago) |
| Date of dissolution: | 28 Sep 2018 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (7 years ago) |
| Document Number: | N14000005579 |
| FEI/EIN Number |
26-1703949
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 3165 SW FAMBROUGH STREET, PORT ST. LUCIE, FL, 34953 |
| Mail Address: | 3165 SW FAMBROUGH STREET, PORT ST. LUCIE, FL, 34953 |
| ZIP code: | 34953 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679914741 | 2013-07-17 | 2013-07-17 | 3165 SW FAMBROUGH ST, PORT ST LUCIE, FL, 349534541, US | 3165 SW FAMBROUGH ST, PORT ST LUCIE, FL, 349534541, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 772-878-1010 |
| Fax | 7723451402 |
Authorized person
| Name | TISA FORTE |
| Role | OWNER |
| Phone | 7728781010 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | 11368 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000585500 |
| State | FL |
| Issuer | MEDICAID |
| Number | 000179100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FORTE TISA D | President | 3165 SW FAMBROUGH STREET, PORT ST LUCIE, FL, 34953 |
| FORTE TISA D | Vice President | 3165 SW FAMBROUGH STREET, PORT ST LUCIE, FL, 34953 |
| FORTE TISA D | Secretary | 3165 SW FAMBROUGH STREET, PORT ST LUCIE, FL, 34953 |
| LAMAR TRELLIS | Agent | 3165 SW FAMBROUGH STREET, PORT ST. LUCIE, FL, 34953 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | - | - |
| REINSTATEMENT | 2016-03-17 | - | - |
| REGISTERED AGENT NAME CHANGED | 2016-03-17 | LAMAR, TRELLIS | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-04-04 |
| REINSTATEMENT | 2016-03-17 |
| Domestic Non-Profit | 2014-06-11 |
Date of last update: 03 Apr 2025
Sources: Florida Department of State
