| Entity Name: | TOTAL LIFE COMMUNITY HEALTH INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 03 Mar 2021 (4 years ago) |
| Document Number: | N21000002560 |
| FEI/EIN Number | 86-2379213 |
| Address: | 215 ORANGE STREET, AUBURNDALE, FL, 33823, US |
| Mail Address: | 215 ORANGE STREET, AUBURNDALE, FL, 33823, US |
| ZIP code: | 33823 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538744578 | 2021-03-11 | 2023-12-22 | 215 ORANGE ST STE 4, AUBURNDALE, FL, 338233447, US | 215 ORANGE ST STE 4, AUBURNDALE, FL, 338233447, US | |||||||||||||
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| Phone | +1 863-812-4334 |
Authorized person
| Name | DARLING ST JEAN |
| Role | HEALTH ADMINISTRATOR |
| Phone | 8638124334 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ST JEAN DARLING | Agent | 215 ORANGE STREET, AUBURNDALE, FL, 33823 |
| Name | Role | Address |
|---|---|---|
| ST JEAN DARLING | Director | 215 ORANGE STREET, AUBURNDALE, FL, 33823 |
| DEAN BYRON DO | Director | 215 ORANGE STREET, AUBURNDALE, FL, 33823 |
| COWART CLAYTON | Director | 3707 AVE M NW, WINTER HAVEN, FL, 33880 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-24 | 215 ORANGE STREET, STE 3, AUBURNDALE, FL 33823 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-24 | 215 ORANGE STREET, STE 3, AUBURNDALE, FL 33823 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-24 | 215 ORANGE STREET, STE 4, AUBURNDALE, FL 33823 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-24 |
| ANNUAL REPORT | 2023-04-30 |
| ANNUAL REPORT | 2022-04-27 |
| Domestic Non-Profit | 2021-03-03 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
