| Entity Name: | TIME OUT RESPITE CARE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Not For Profit Corporation |
| Status: | Inactive |
| Date Filed: | 06 Jun 1989 (36 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | N32679 |
| FEI/EIN Number | 65-0155190 |
| Address: | 950 Tamiami trail, 103, PORT CHARLOTTE, FL 33953 |
| Mail Address: | 950 Tamiami trail, 103, PORT CHARLOTTE, FL 33953 |
| ZIP code: | 33953 |
| County: | Charlotte |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265735179 | 2010-12-15 | 2010-12-15 | 24246 HARBORVIEW RD, PORT CHARLOTTE, FL, 339802232, US | 24246 HARBORVIEW RD, PORT CHARLOTTE, FL, 339802232, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 941-743-3883 |
| Fax | 9417434369 |
Authorized person
| Name | MRS. SHARON CHRISTINA HARTZELL |
| Role | ADMINISTRATOR |
| Phone | 9417433883 |
Taxonomy
| Taxonomy Code | 251C00000X - Developmentally Disabled Services Day Training Agency |
| License Number | 089079 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| License Number | 089079 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 343900000X - Non-emergency Medical Transport (VAN) |
| License Number | 089079 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 385HR2065X - Child Physical Disabilities Respite Care |
| License Number | 089079 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 347800000X |
| State | FL |
| Issuer | MEDICAID |
| Number | 251C00000X |
| State | FL |
| Issuer | MEDICAID |
| Number | 385H00000X |
| State | FL |
| Issuer | MEDICAID |
| Number | 253200000X |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MAZZONI, JAMI DAWN | Agent | 950 Tamiami trail, 103, PORT CHARLOTTE, FL 33953 |
| Name | Role | Address |
|---|---|---|
| WILLIAMS, BETH | President | 18500 O'HARA DRIVE, PORT CHARLOTTE, FL 33948 |
| Name | Role | Address |
|---|---|---|
| MAZZONI, JOSEPH | Vice President | 22347 ADORN STREET, PORT CHARLOTTE, FL 33952 |
| Name | Role | Address |
|---|---|---|
| Exler-Parsons, Kimberly | Member | 24246 HARBOR VIEW RD, PORT CHARLOTTE, FL 33980 |
| Name | Role | Address |
|---|---|---|
| MAZZONI, JAMI | ADMINISTRATOR | 950 Tamiami trail, 103 PORT CHARLOTTE, FL 33953 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2022-05-02 | 950 Tamiami trail, 103, PORT CHARLOTTE, FL 33953 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-05-02 | 950 Tamiami trail, 103, PORT CHARLOTTE, FL 33953 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-05-02 | 950 Tamiami trail, 103, PORT CHARLOTTE, FL 33953 | No data |
| REGISTERED AGENT NAME CHANGED | 2016-11-08 | MAZZONI, JAMI DAWN | No data |
| REINSTATEMENT | 2016-11-08 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| CANCEL ADM DISS/REV | 2009-10-19 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| AMENDMENT | 1990-07-05 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J23000024372 | ACTIVE | 1000000940953 | CHARLOTTE | 2023-01-11 | 2033-01-18 | $ 1,858.80 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, FORT MYERS SERVICE CENTER, 2295 VICTORIA AVE STE 270, FORT MYERS FL339013871 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-05-02 |
| ANNUAL REPORT | 2021-02-01 |
| ANNUAL REPORT | 2020-06-27 |
| ANNUAL REPORT | 2019-02-22 |
| ANNUAL REPORT | 2018-04-10 |
| ANNUAL REPORT | 2017-03-16 |
| REINSTATEMENT | 2016-11-08 |
| ANNUAL REPORT | 2015-02-23 |
| ANNUAL REPORT | 2014-07-29 |
| ANNUAL REPORT | 2013-01-22 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
