| Entity Name: | CENTER FOR AGING AND REHABILITATION OF LAKE WORTH, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 12 Jul 2021 (4 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 15 Nov 2024 (3 months ago) |
| Document Number: | N21000008409 |
| FEI/EIN Number | 87-2022874 |
| Address: | 4445 Pine Forest Drive, Lake Worth, FL, 33463, US |
| Mail Address: | C/O TKP Accounting, 3550 Powerline, Oakland Park, FL, 33309, US |
| ZIP code: | 33463 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1144982919 | 2021-10-09 | 2021-11-23 | 3550 POWERLINE RD, FORT LAUDERDALE, FL, 333095917, US | 4445 PINE FOREST DR, LAKE WORTH, FL, 334634676, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 954-367-4597 |
| Fax | 9543674564 |
Authorized person
| Name | MARY ANNE WOOD |
| Role | AUTHORIZED OFFICIAL |
| Phone | 9543674597 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| kelly robert | Agent | 2699 Stirling Road, C403B, Ft. Lauderdale, FL, 33312 |
| Name | Role | Address |
|---|---|---|
| BROCK ALAN | Director | 12460 CRABAPPLE RD STE 202-308, ALPHARETTA, GA, 30004 |
| BARRETT ALEX | Director | 100 S. STRATFORD RD, SUITE 400, WINSTON-SALEM, NC, 27104 |
| HOGE BRETT | Director | 1100 S STRATFORD RD STE 400, WINSTON-SALEM, NC, 27104 |
| kelly robert | Director | 2699 Stirling Road, C403B, Ft. Lauderadale, FL, 33312 |
| Name | Role | Address |
|---|---|---|
| kelly robert | Secretary | 2699 Stirling Road, C403B, Ft. Lauderadale, FL, 33312 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000141488 | CROSSINGS CARE CENTER | ACTIVE | 2021-10-20 | 2026-12-31 | No data | 100 SE 2ND STREET,SUITE 2000, MIAMI, FL, 33131 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-11-15 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-09-02 | 4445 Pine Forest Drive, Lake Worth, FL 33463 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-09-02 | kelly, robert | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-09-02 | 2699 Stirling Road, C403B, Ft. Lauderdale, FL 33312 | No data |
| CHANGE OF MAILING ADDRESS | 2022-01-31 | 4445 Pine Forest Drive, Lake Worth, FL 33463 | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-11-15 |
| ANNUAL REPORT | 2023-04-12 |
| AMENDED ANNUAL REPORT | 2022-09-02 |
| ANNUAL REPORT | 2022-01-31 |
| Domestic Non-Profit | 2021-07-12 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
