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PALM LAKE VILLAGE HOUSING CORPORATION - Florida Company Profile

Company Details

Entity Name: PALM LAKE VILLAGE HOUSING CORPORATION
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: 07 Jul 1986 (39 years ago)
Last Event: AMENDED AND RESTATED ARTICLES
Event Date Filed: 19 May 2014 (11 years ago)
Document Number: N15843
FEI/EIN Number 592691849

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 11479 ULMERTON ROAD, LARGO, FL, 33778
Mail Address: 11479 ULMERTON ROAD, LARGO, FL, 33778
ZIP code: 33778
County: Pinellas
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1184962003 2013-01-28 2019-09-05 3800 62ND AVE N, PINELLAS PARK, FL, 337816055, US 3800 62ND AVE N, PINELLAS PARK, FL, 337816055, US

Contacts

Phone +1 727-489-6440

Authorized person

Name LISA ELLIOTT
Role ADMINISTRATOR
Phone 7274896440

Taxonomy

Taxonomy Code 310400000X - Assisted Living Facility
License Number AL10314
State FL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 001645100
State FL

Key Officers & Management

Name Role Address
TOMCZAK ALEN Director 11479 ULMERTON ROAD, LARGO, FL, 33778
HICKEY VERONICA President 11479 ULMERTON ROAD, LARGO, FL, 33778
MINEO WAYNE Director 11479 ULMERTON ROAD, LARGO, FL, 33778
FIREBAUGH CHLOE Vice President 11479 ULMERTON ROAD, LARGO, FL, 33778
BRICKFIELD NEIL Gene 11479 ULMERTON ROAD, LARGO, FL, 33778
GILMORE RICARDO LESQ. Agent FIFTH THIRD PLAZA, 201 EAST KENNEDY BLVD, TAMPA, FL, 33602

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G23000112501 MAGNOLIA GARDENS ALF ACTIVE 2023-09-13 2028-12-31 - 11479 ULMERTON ROAD, LARGO, FL, 33778
G22000024554 CRYSTAL LAKES MANOR ACTIVE 2022-03-01 2027-12-31 - 11479 ULMERTON ROAD, LARGO, FL, 33778
G22000024553 PALM LAKE VILLAGE ACTIVE 2022-03-01 2027-12-31 - 11479 ULMERTON ROAD, LARGO, FL, 33778
G17000091589 MAGNOLIA GARDENS ALF EXPIRED 2017-08-18 2022-12-31 - 3800 62ND AVE N, PINELLAS PARK, FL, 33781
G11000011969 CRYSTAL LAKES MANOR EXPIRED 2011-01-31 2016-12-31 - 4100 62ND AVE N, PINELLAS PARK, FL, 33781
G11000011973 MAGNOLIA GARDENS ALF EXPIRED 2011-01-31 2016-12-31 - 3800 62ND AVE N, PINELLAS PARK, FL, 33781
G11000011964 PALM LAKE VILLAGE EXPIRED 2011-01-31 2016-12-31 - 1515 COUNTY ROAD ONE, DUNEDIN, FL, 34698

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2025-01-29 Jennings, Todd A., ESQ. -
REGISTERED AGENT ADDRESS CHANGED 2025-01-29 625 Court Street, Suite 200, Clearwater, FL 33756 -
AMENDED AND RESTATEDARTICLES 2014-05-19 - -
CHANGE OF PRINCIPAL ADDRESS 2001-06-22 11479 ULMERTON ROAD, LARGO, FL 33778 -
CHANGE OF MAILING ADDRESS 2001-06-22 11479 ULMERTON ROAD, LARGO, FL 33778 -
AMENDMENT 1987-07-29 - -

Documents

Name Date
ANNUAL REPORT 2025-01-29
ANNUAL REPORT 2024-04-09
ANNUAL REPORT 2023-04-24
ANNUAL REPORT 2022-03-15
ANNUAL REPORT 2021-04-14
ANNUAL REPORT 2020-03-09
ANNUAL REPORT 2019-04-15
ANNUAL REPORT 2018-03-05
ANNUAL REPORT 2017-01-09
AMENDED ANNUAL REPORT 2016-06-28

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
1410808209 2020-07-30 0455 PPP 11479 Ulmerton Road,, Largo, FL, 33778
Loan Status Date 2021-05-14
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 303215
Loan Approval Amount (current) 303215
Undisbursed Amount 0
Franchise Name -
Lender Location ID 45120
Servicing Lender Name Valley National Bank
Servicing Lender Address 615 Main Ave, PASSAIC, NJ, 07055-5066
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Largo, PINELLAS, FL, 33778-0001
Project Congressional District FL-13
Number of Employees 46
NAICS code 813211
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 45120
Originating Lender Name Valley National Bank
Originating Lender Address PASSAIC, NJ
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 305438.58
Forgiveness Paid Date 2021-04-27
6530188406 2021-02-10 0455 PPS 11479 Ulmerton Rd, Largo, FL, 33778-1602
Loan Status Date 2021-10-15
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 256942
Loan Approval Amount (current) 256942
Undisbursed Amount 0
Franchise Name -
Lender Location ID 45120
Servicing Lender Name Valley National Bank
Servicing Lender Address 615 Main Ave, PASSAIC, NJ, 07055-5066
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Largo, PINELLAS, FL, 33778-1602
Project Congressional District FL-13
Number of Employees 44
NAICS code 813211
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 45120
Originating Lender Name Valley National Bank
Originating Lender Address PASSAIC, NJ
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 258526.48
Forgiveness Paid Date 2021-09-22

Date of last update: 01 Apr 2025

Sources: Florida Department of State