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BRANDYWINE CONVALESCENT CENTER, INC. - Florida Company Profile

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Company Details

Entity Name: BRANDYWINE CONVALESCENT CENTER, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 27 Mar 2000 (25 years ago)
Document Number: P00000032167
FEI/EIN Number 593635204
Mail Address: PO Box 530787, DEBARY, FL, 32753, US
Address: 1801 North Lake Mariam Drive, WINTER HAVEN, FL, 33884, US
ZIP code: 33884
City: Winter Haven
County: Polk
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
HERZOG L P President PO Box 530787, DEBARY, FL, 32753
Swain W S Secretary P.O. BOX 71030, MYRTLE BEACH, SC, 29572
- Agent -

Unique Entity ID

CAGE Code:
3SAK3
UEI Expiration Date:
2021-02-02

Business Information

Doing Business As:
BRANDYWYNE HEALTHCARE CENTER
Activation Date:
2020-02-03
Initial Registration Date:
2004-03-11

Commercial and government entity program

CAGE number:
3SAK3
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2023-06-25
CAGE Expiration:
2026-01-28

Contact Information

POC:
COREY HAMIL

National Provider Identifier

NPI Number:
1518941582
Certification Date:
2020-10-08

Authorized Person:

Name:
VICTORIA LYNN SHARPLESS
Role:
DIRECTOR OF ACCOUNTING
Phone:

Taxonomy:

Selected Taxonomy:
314000000X - Skilled Nursing Facility
Is Primary:
Yes

Contacts:

Fax:
8632996427

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G16000059242 BRANDYWYNE HEALTH CARE CENTER EXPIRED 2016-06-15 2021-12-31 - PO BOX 530206, DEBARY, FL, 32753

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2024-04-11 1801 North Lake Mariam Drive, WINTER HAVEN, FL 33884 -
CHANGE OF PRINCIPAL ADDRESS 2016-04-27 1801 North Lake Mariam Drive, WINTER HAVEN, FL 33884 -

Documents

Name Date
ANNUAL REPORT 2024-04-11
ANNUAL REPORT 2023-04-17
ANNUAL REPORT 2022-04-14
ANNUAL REPORT 2021-04-21
ANNUAL REPORT 2020-04-09
ANNUAL REPORT 2019-04-10
ANNUAL REPORT 2018-04-17
ANNUAL REPORT 2017-04-24
ANNUAL REPORT 2016-04-27
Reg. Agent Change 2016-01-29

USAspending Awards / Contracts

Procurement Instrument Identifier:
36C24821N0419
Award Or Idv Flag:
AWARD
Award Type:
DELIVERY ORDER
Action Obligation:
700000.00
Base And Exercised Options Value:
700000.00
Base And All Options Value:
700000.00
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2021-03-01
Description:
NURSING HOME SERVICES
Naics Code:
623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product Or Service Code:
Q402: MEDICAL- NURSING HOME CARE CONTRACTS
Procurement Instrument Identifier:
36C24820N0328
Award Or Idv Flag:
AWARD
Award Type:
DELIVERY ORDER
Action Obligation:
600000.00
Base And Exercised Options Value:
600000.00
Base And All Options Value:
600000.00
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2020-03-01
Description:
NURSING HOME SERVICES
Naics Code:
623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product Or Service Code:
Q402: MEDICAL- NURSING HOME CARE CONTRACTS
Procurement Instrument Identifier:
36C24819N0488
Award Or Idv Flag:
AWARD
Award Type:
DELIVERY ORDER
Action Obligation:
560759.00
Base And Exercised Options Value:
560759.00
Base And All Options Value:
560759.00
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2019-03-01
Description:
NURSING HOME SERVICES
Naics Code:
623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product Or Service Code:
Q402: MEDICAL- NURSING HOME CARE CONTRACTS

USAspending Awards / Financial Assistance

Date:
2020-04-08
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
1076168.10
Total Face Value Of Loan:
1076168.10

Paycheck Protection Program

Jobs Reported:
124
Initial Approval Amount:
$1,076,168.1
Date Approved:
2020-04-08
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$1,076,168.1
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$1,088,345.02
Servicing Lender:
The Park National Bank
Use of Proceeds:
Payroll: $807,126.08
Utilities: $53,808.4
Rent: $215,233.62

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Date of last update: 03 Aug 2025

Sources: Florida Department of State