| Entity Name: | HOME AGAIN OF SOUTHWEST FLORIDA, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 14 Apr 2000 (25 years ago) |
| Document Number: | P00000037798 |
| FEI/EIN Number | 65-0998931 |
| Address: | 3392 Como Street, PORT CHARLOTTE, FL 33948 |
| Mail Address: | PO Box 380219, PORT CHARLOTTE, FL 33948 |
| ZIP code: | 33948 |
| County: | Charlotte |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750684809 | 2010-12-13 | 2010-12-13 | PO BOX 380183, MURDOCK, FL, 339380183, US | 1357 RAMSDEL ST, PORT CHARLOTTE, FL, 339522887, US | |||||||||||||||||||||||||||
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| Phone | +1 941-743-4857 |
| Fax | 8009214989 |
Authorized person
| Name | ANGELA ASHLEY |
| Role | PRESIDENT |
| Phone | 9417434857 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 320900000X - Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID WAIVER |
| Number | 678473996 |
| Name | Role | Address |
|---|---|---|
| ASHLEY, ANGELA K | Agent | 3392 COMO STREET, PORT CHARLOTTE, FL 33948 |
| Name | Role | Address |
|---|---|---|
| ASHLEY, ANGELA K | President | 3392 COMO STREET, PORT CHARLOTTE, FL 33948 |
| Name | Role | Address |
|---|---|---|
| ASHLEY, ANGELA K | Director | 3392 COMO STREET, PORT CHARLOTTE, FL 33948 |
| PAYNE, ALVIN | Director | 2598 Jaremko Ave. SE, PALM BAY, FL 32909 |
| ASHLEY, RUBELLE | Director | 3392 COMO STREET, PORT CHARLOTTE, FL 33948 |
| Name | Role | Address |
|---|---|---|
| PAYNE, ALVIN | Vice President | 2598 Jaremko Ave. SE, PALM BAY, FL 32909 |
| Name | Role | Address |
|---|---|---|
| ASHLEY, RUBELLE | Treasurer | 3392 COMO STREET, PORT CHARLOTTE, FL 33948 |
| Name | Role | Address |
|---|---|---|
| Scott, Darnell | Authorized Member | 2829 Cabaret St., Port Charlotte, FL 33948 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-04-21 | 3392 Como Street, PORT CHARLOTTE, FL 33948 | No data |
| CHANGE OF MAILING ADDRESS | 2020-04-21 | 3392 Como Street, PORT CHARLOTTE, FL 33948 | No data |
| REGISTERED AGENT NAME CHANGED | 2005-08-16 | ASHLEY, ANGELA K | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-08 |
| ANNUAL REPORT | 2023-02-20 |
| ANNUAL REPORT | 2022-03-24 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-04-14 |
| ANNUAL REPORT | 2019-04-10 |
| ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2017-01-17 |
| ANNUAL REPORT | 2016-03-29 |
| ANNUAL REPORT | 2015-04-22 |
Date of last update: 31 Jan 2025
Sources: Florida Department of State
