| Entity Name: | ALLIANCE FOUNDATION OF FLORIDA, INC. |
| 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: | 29 Jun 1999 (26 years ago) |
| Document Number: | N99000004000 |
| FEI/EIN Number |
582476611
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Mail Address: | P.O. Box 228, Clifton, VA, 20124, US |
| Address: | 3989 CHAIN BRIDGE ROAD, FAIRFAX, VA, 22030, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952720294 | 2014-04-15 | 2014-04-15 | 595 N WILLIAMSON BLVD, DAYTONA BEACH, FL, 321147185, US | 595 N WILLIAMSON BLVD, DAYTONA BEACH, FL, 321147185, US | |||||||||||||||||||||||||
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| Phone | +1 386-257-4400 |
| Fax | 3862574372 |
Authorized person
| Name | MR. RANDOLPH LEE KERNON II |
| Role | EXECUTIVE DIRECTOR |
| Phone | 3865474686 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL5400 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | STATE OF FLORIDA AHCA |
| Number | AL5400 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALLIANCE FOUNDATION OF FLORIDA, INC. 401(K) PLAN | 2022 | 582476611 | 2023-05-26 | ALLIANCE FOUNDATION OF FLORIDA, | 27 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2023-05-26 |
| Name of individual signing | LAURA STONE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2012-01-01 |
| Business code | 623000 |
| Sponsor’s telephone number | 3862574400 |
| Plan sponsor’s address | 570 NATIONAL HEALTHCARE DR, DAYTONA BEACH, FL, 32114 |
Signature of
| Role | Plan administrator |
| Date | 2022-05-25 |
| Name of individual signing | LAURA STONE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2012-01-01 |
| Business code | 623000 |
| Sponsor’s telephone number | 3862574400 |
| Plan sponsor’s address | 595 N WILLIAMSON BLVD, DAYTONA BEACH, FL, 32114 |
Signature of
| Role | Plan administrator |
| Date | 2021-08-02 |
| Name of individual signing | LAURA STONE |
| Valid signature | Filed with authorized/valid electronic signature |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2012-01-01 |
| Business code | 623000 |
| Sponsor’s telephone number | 3862574400 |
| Plan sponsor’s address | 595 N WILLIAMSON BLVD, DAYTONA BEACH, FL, 32114 |
Signature of
| Role | Plan administrator |
| Date | 2020-06-23 |
| Name of individual signing | LSTONE0528 |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2012-01-01 |
| Business code | 623000 |
| Sponsor’s telephone number | 3862574400 |
| Plan sponsor’s address | 595 N WILLIAMSON BLVD, DAYTONA BEACH, FL, 32114 |
Signature of
| Role | Plan administrator |
| Date | 2020-06-30 |
| Name of individual signing | LAURA STONE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2012-01-01 |
| Business code | 623000 |
| Sponsor’s telephone number | 3862574400 |
| Plan sponsor’s address | 595 N WILLIAMSON BLVD, DAYTONA BEACH, FL, 32114 |
Signature of
| Role | Plan administrator |
| Date | 2019-05-30 |
| Name of individual signing | LAURA STONE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2012-01-01 |
| Business code | 623000 |
| Sponsor’s telephone number | 3862574400 |
| Plan sponsor’s address | 595 N WILLIAMSON BLVD, DAYTONA BEACH, FL, 32114 |
Signature of
| Role | Plan administrator |
| Date | 2018-05-17 |
| Name of individual signing | LAURA STONE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2012-01-01 |
| Business code | 623000 |
| Sponsor’s telephone number | 3862574400 |
| Plan sponsor’s address | 595 N WILLIAMSON BLVD, DAYTONA BEACH, FL, 32114 |
Signature of
| Role | Plan administrator |
| Date | 2017-05-18 |
| Name of individual signing | LAURA STONE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2012-01-01 |
| Business code | 623000 |
| Sponsor’s telephone number | 3862574400 |
| Plan sponsor’s address | 595 N WILLIAMSON BLVD, DAYTONA BEACH, FL, 32114 |
Signature of
| Role | Plan administrator |
| Date | 2016-05-31 |
| Name of individual signing | NANCY BARKER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2012-01-01 |
| Business code | 623000 |
| Sponsor’s telephone number | 3862574400 |
| Plan sponsor’s address | 595 N WILLIAMSON BLVD, DAYTONA BEACH, FL, 32114 |
Signature of
| Role | Plan administrator |
| Date | 2015-07-01 |
| Name of individual signing | NANCY BARKER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| HOSTLER ROBERT P | President | 3989 CHAIN BRIDGE ROAD, FAIRFAX, VA, 22030 |
| PURDUM JIM S | Secretary | 3989 CHAIN BRIDGE ROAD, FAIRFAX, VA, 22030 |
| HOSTLER ROBERT P | Director | 3989 CHAIN BRIDGE ROAD, FAIRFAX, VA, 22030 |
| REGISTERED AGENTS INC | Agent | - |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000057073 | TAFFI MEDICAL | ACTIVE | 2020-05-22 | 2025-12-31 | - | 3989 CHAIN BRIGE ROAD, FAIRFAX, VA, 22030 |
| G20000037388 | INDIGO PALMS AT THE MANOR | ACTIVE | 2020-04-01 | 2025-12-31 | - | ALLIANCE FOUNDATION OF FLORIDA, INC., 3989 CHAIN BRIDGE ROAD, FAIRFAX, VA, 22030 |
| G14000080596 | INDIGO PALMS AT THE MANOR | EXPIRED | 2014-08-05 | 2019-12-31 | - | 3989 CHAIN BRIDGE ROAD, THE LEIGH BUILDING, FAIRFAX, VA, 22030 |
| G14000080603 | INDIGO PALMS AT THE MANOR | EXPIRED | 2014-08-05 | 2019-12-31 | - | 595 N.WILLIAMSON BOULEVARD, DAYTONA BEACH, FL, 32114 |
| G14000080607 | THE PALMS AT INDIGO MANOR | EXPIRED | 2014-08-05 | 2019-12-31 | - | 595 N.WILLIAMSON BOULEVARD, DAYTONA BEACH, FL, 32114 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-07-17 | 3989 CHAIN BRIDGE ROAD, FAIRFAX, VA 22030 | - |
| REGISTERED AGENT NAME CHANGED | 2019-05-17 | REGISTERED AGENTS INC. | - |
| REGISTERED AGENT ADDRESS CHANGED | 2019-05-17 | 7901 4TH ST N STE 300, ST PETERSBURG, FL 33702 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2012-04-24 | 3989 CHAIN BRIDGE ROAD, FAIRFAX, VA 22030 | - |
| Title | Case Number | Docket Date | Status | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| MARIE J. LYNN AND MARK W. LYNN VS ALLIANCE FOUNDATION OF FLORIDA, INC. AND RANDOLPH L. KERNON, I I | 5D2016-3822 | 2016-11-09 | Closed | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Name | MARK W. LYNN |
| Role | Appellant |
| Status | Active |
| Name | MARIE J. LYNN |
| Role | Appellant |
| Status | Active |
| Representations | Joanna Greber Dettloff, Megan Gisclar Colter |
| Name | ALLIANCE FOUNDATION OF FLORIDA, INC. |
| Role | Appellee |
| Status | Active |
| Representations | Jessica N. Cochran, Ronald E. Bush |
| Name | RANDOLPH L. KERNON, I I |
| Role | Appellee |
| Status | Active |
| Name | Hon. Michael S. Orfinger |
| Role | Judge/Judicial Officer |
| Status | Active |
| Name | Volusia Cty Circuit Crt Clerk |
| Role | Lower Tribunal Clerk |
| Status | Active |
Docket Entries
| Docket Date | 2017-06-19 |
| Type | Mandate |
| Subtype | Mandate |
| Description | Mandate |
| Docket Date | 2017-06-19 |
| Type | Record |
| Subtype | Returned Records |
| Description | Returned Records ~ NO RECORD EFILED |
| Docket Date | 2017-05-30 |
| Type | Disposition by Opinion |
| Subtype | Affirmed |
| Description | Affirmed - Per Curiam Affirmed ~ PCA |
| Docket Date | 2017-05-09 |
| Type | Notice |
| Subtype | Notice |
| Description | Notice ~ OF UNAVAILABILITY |
| On Behalf Of | ALLIANCE FOUNDATION OF FLORIDA |
| Docket Date | 2017-02-24 |
| Type | Brief |
| Subtype | Reply Brief |
| Description | Appellant's Reply Brief |
| On Behalf Of | MARIE J. LYNN |
| Docket Date | 2017-02-07 |
| Type | Brief |
| Subtype | Answer Brief |
| Description | Appellee's Answer Brief |
| On Behalf Of | ALLIANCE FOUNDATION OF FLORIDA |
| Docket Date | 2017-01-24 |
| Type | Order |
| Subtype | Order on Motion for Extension of Time to Serve Answer Brief |
| Description | Order Grant EOT for Answer Brief |
| Docket Date | 2017-01-23 |
| Type | Motions Extensions |
| Subtype | Motion for Extension of Time to Serve Answer Brief |
| Description | Mot. for Extensio of time to file Answer Brief |
| On Behalf Of | ALLIANCE FOUNDATION OF FLORIDA |
| Docket Date | 2016-12-21 |
| Type | Motions Extensions |
| Subtype | Motion for Extension of Time to Serve Answer Brief |
| Description | Mot. for Extensio of time to file Answer Brief |
| On Behalf Of | ALLIANCE FOUNDATION OF FLORIDA |
| Docket Date | 2016-12-21 |
| Type | Order |
| Subtype | Order on Motion for Extension of Time to Serve Answer Brief |
| Description | Order Grant EOT for Answer Brief |
| Docket Date | 2016-12-09 |
| Type | Brief |
| Subtype | Appendix |
| Description | Appendix for Initial Brief |
| On Behalf Of | MARIE J. LYNN |
| Docket Date | 2016-11-30 |
| Type | Order |
| Subtype | Order Discharging Show Cause Order |
| Description | ORD-Discharging Show Cause |
| Docket Date | 2016-11-29 |
| Type | Response |
| Subtype | Response |
| Description | RESPONSE |
| On Behalf Of | ALLIANCE FOUNDATION OF FLORIDA |
| Docket Date | 2016-11-21 |
| Type | Order |
| Subtype | Show Cause |
| Description | Show Cause - Failure to Register ~ DISCHARGED PER 11/30 ORDER |
| Docket Date | 2016-11-17 |
| Type | Order |
| Subtype | Order on Motion for Extension of Time to Serve Initial Brief |
| Description | Order Grant EOT for Initial Brief |
| Docket Date | 2016-11-16 |
| Type | Motions Extensions |
| Subtype | Motion for Extension of Time to Serve Initial Brief |
| Description | Mot. for Extension of time to file Initial Brief |
| On Behalf Of | MARIE J. LYNN |
| Docket Date | 2016-11-09 |
| Type | Letter |
| Subtype | Acknowledgment Letter |
| Description | Acknowledgement Letter 1 |
| Docket Date | 2016-11-09 |
| Type | Misc. Events |
| Subtype | Fee Status |
| Description | A3:Paid In Full - $300 |
| Docket Date | 2016-11-09 |
| Type | Notice |
| Subtype | Notice of Appeal |
| Description | Notice of Appeal Filed ~ FILED BELOW 11/4/16 |
| On Behalf Of | MARIE J. LYNN |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-08 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-02-09 |
| ANNUAL REPORT | 2020-04-15 |
| Reg. Agent Change | 2019-05-17 |
| ANNUAL REPORT | 2019-04-16 |
| ANNUAL REPORT | 2018-03-07 |
| ANNUAL REPORT | 2017-04-12 |
| ANNUAL REPORT | 2016-03-13 |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| - | IDV | VA248BO0008 | 2010-01-01 | - | - | |||||||||||||||||||||||||
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| Obligated Amount | 0.00 |
| Potential Award Amount | 100000.00 |
Description
| Title | COMMUNITY NURSING HOME |
| NAICS Code | 623110: NURSING CARE FACILITIES |
| Product and Service Codes | Q402: NURSING HOME CARE CONTRACTS |
Recipient Details
| Recipient | ALLIANCE FOUNDATION OF FLORIDA INC |
| UEI | EQGYZRZVCAD6 |
| Recipient Address | 595 WILLIAMSON BLVD, DAYTONA BEACH, VOLUSIA, FLORIDA, 321147185, UNITED STATES |
| Unique Award Key | CONT_AWD_VA573B0008_3600_VA248BO0008_3600 |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Award Amounts
| Obligated Amount | 277889.00 |
| Current Award Amount | 277889.00 |
| Potential Award Amount | 277889.00 |
Description
| Title | COMMUNITY NURSING HOME |
| NAICS Code | 623110: NURSING CARE FACILITIES |
| Product and Service Codes | Q402: NURSING HOME CARE CONTRACTS |
Recipient Details
| Recipient | ALLIANCE FOUNDATION OF FLORIDA INC |
| UEI | EQGYZRZVCAD6 |
| Recipient Address | 595 WILLIAMSON BLVD, DAYTONA BEACH, VOLUSIA, FLORIDA, 321147185, UNITED STATES |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
