| Entity Name: | ELDER CARE OF ALACHUA COUNTY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 28 Jan 1991 (34 years ago) |
| Document Number: | N41822 |
| FEI/EIN Number | 593051104 |
| Mail Address: | P. O. BOX 100303, GAINESVILLE, FL, 32610, US |
| Address: | 5701 NW 34TH BLVD., GAINESVILLE, FL, 32653, US |
| ZIP code: | 32653 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720387673 | 2011-03-17 | 2011-03-17 | 3515 NW 98TH ST, GAINESVILLE, FL, 326065008, US | 3515 NW 98TH ST, GAINESVILLE, FL, 326065008, US | |||||||||||||||||||||||
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| Phone | +1 352-265-0789 |
Authorized person
| Name | MR. ANTHONY MARK CLARIZIO |
| Role | EXECUTIVE DIRECTOR |
| Phone | 3522659243 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | 5638 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 025079102 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| YOUNG THOMAS WILLIAM | Agent | 3007 SW Williston Rd, GAINESVILLE, FL, 32608 |
| Name | Role | Address |
|---|---|---|
| HOLT JOCELYN | Director | 1035 N. W. 57TH STREET, GAINESVILLE, FL, 32605 |
| TONEY A. SCOTT | Director | 925-B NW 56th Terrace, GAINESVILLE, FL, 32605 |
| CRUZ-ALMEIDA YENISEL | Director | 2004 MOWRY ROAD, GAINESVILLE, FL, 32611 |
| HERSEY TONI | Director | 3300 SW WILLISTON ROAD, GAINESVILLE, FL, 32608 |
| Name | Role | Address |
|---|---|---|
| BENTON JERRY | Vice Chairman | P. O. BOX 147029, GAINESVILLE, FL, 32614 |
| Name | Role | Address |
|---|---|---|
| HOLT JOCELYN | Chairman | 1035 N. W. 57TH STREET, GAINESVILLE, FL, 32605 |
| Name | Role | Address |
|---|---|---|
| THORNTON ROBERT | Treasurer | 1329 SW 16TH STREET/BOX 100336, GAINESVILLE, FL, 32610 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000016750 | ELDERCARE MEALS ON WHEELS | EXPIRED | 2014-02-17 | 2019-12-31 | No data | P. O. BOX 100303, GAINESVILLE, FL, 32610 |
| G10000072153 | PRIMETIME INSTITUTE | EXPIRED | 2010-08-05 | 2015-12-31 | No data | 4026 NW 22 DRIVE, GAINESVILLE, FL, 32605 |
| G97056000234 | AL'Z PLACE | ACTIVE | 1997-02-25 | 2027-12-31 | No data | C/O UF HEALTH SHANDS LEGAL SERVICES, P.O. BOX 100303, GAINESVILLE, FL, 32610 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT AND NAME CHANGE | 2000-05-30 | ELDER CARE OF ALACHUA COUNTY, INC. | No data |
| AMENDMENT | 1996-02-05 | No data | No data |
| AMENDMENT | 1996-01-16 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
