| Entity Name: | MARY'S HOME, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 27 Jun 2001 (24 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 08 Oct 2021 (3 years ago) |
| Document Number: | P01000063888 |
| FEI/EIN Number | 651116552 |
| Address: | 14158 NW 88 PLACE, MIAMI LAKES, FL, 33018, US |
| Mail Address: | 14158 NW 88 PLACE, MIAMI LAKES, FL, 33018, US |
| ZIP code: | 33018 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043410103 | 2007-07-18 | 2024-11-08 | 14158 NW 88 PLACE, MIAMI LAKES, FL, 33018, US | 14158 NW 88 PLACE, MIAMI LAKES, FL, 33018, US | |||||||||||||||||||||||||
|
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| Phone | +1 786-401-6639 |
| Fax | 7864008606 |
Authorized person
| Name | LEDEIDY PEREZ |
| Role | OWNER |
| Phone | 7867151896 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL10073 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 141203500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Perez Ledeidy | Agent | 14158 NW 88 PLACE, MIAMI LAKES, FL, 33018 |
| Name | Role | Address |
|---|---|---|
| Perez Ledeidy | President | 14158 NW 88 PLACE, MIAMI LAKES, FL, 33018 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-11-01 | 14158 NW 88 PLACE, MIAMI LAKES, FL 33018 | No data |
| CHANGE OF MAILING ADDRESS | 2024-11-01 | 14158 NW 88 PLACE, MIAMI LAKES, FL 33018 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-11-01 | 14158 NW 88 PLACE, MIAMI LAKES, FL 33018 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-08-01 | Perez, Ledeidy | No data |
| AMENDMENT | 2021-10-08 | No data | No data |
| REINSTATEMENT | 2010-12-23 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-17 |
| AMENDED ANNUAL REPORT | 2024-11-01 |
| ANNUAL REPORT | 2024-08-01 |
| AMENDED ANNUAL REPORT | 2023-04-18 |
| ANNUAL REPORT | 2023-01-09 |
| ANNUAL REPORT | 2022-03-23 |
| Amendment | 2021-10-08 |
| ANNUAL REPORT | 2021-02-25 |
| ANNUAL REPORT | 2020-04-27 |
| ANNUAL REPORT | 2019-04-24 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
