| Entity Name: | ALTA HEALTHCARE GROUP, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 29 Dec 2001 (23 years ago) |
| Document Number: | P01000122126 |
| FEI/EIN Number | 020547663 |
| Address: | 5520 HOWELL BRANCH RD, WINTER PARK, FL, 32792 |
| Mail Address: | 1179 OAK CREEK COURT, WINTER PARK, FL, 32708 |
| ZIP code: | 32792 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568770634 | 2010-09-22 | 2010-09-22 | 4279 FOX HOLLOW CIR, CASSELBERRY, FL, 327075240, US | 5520 HOWELL BRANCH RD, WINTER PARK, FL, 327929327, US | |||||||||||||||||||||||||
|
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| Phone | +1 407-435-2402 |
| Fax | 4076957720 |
Authorized person
| Name | ALBERT GREEN |
| Role | ADMINISTRATOR |
| Phone | 4074352402 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | 8419 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 143050500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GREEN ALBERT L | Agent | 1179 OAK CREEK COURT, WINTER PARK, FL, 32708 |
| Name | Role | Address |
|---|---|---|
| GREEN ALBERT L | President | 1179 OAK CREEK COURT, WINTER PARK, FL, 32708 |
| Name | Role | Address |
|---|---|---|
| GREEN ROBIN N | Vice President | 1179 OAK CREEK COURT, WINTER PARK, FL, 32708 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000099784 | AIDEN SPRINGS ALF | ACTIVE | 2012-10-11 | 2027-12-31 | No data | 5520 HOWELL BRANCH ROAD, WINTER PARK, FL, 32792 |
| G11000029558 | ALTA HEALTHCARE @ DEERWOOD | EXPIRED | 2011-03-23 | 2016-12-31 | No data | 1179 OAK CREEK COURT, WINTER SPRINGS, FL, 32708 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2011-04-29 | 5520 HOWELL BRANCH RD, WINTER PARK, FL 32792 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-04-29 | 1179 OAK CREEK COURT, WINTER PARK, FL 32708 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-01-20 | 5520 HOWELL BRANCH RD, WINTER PARK, FL 32792 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J17000402745 | TERMINATED | 1000000748295 | ORANGE | 2017-06-28 | 2027-07-13 | $ 3,603.20 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, ORLANDO SERVICE CENTER, 400 W ROBINSON ST STE N302, ORLANDO FL328011759 |
| J16000468243 | TERMINATED | 1000000718116 | ORANGE | 2016-07-25 | 2026-08-04 | $ 3,895.29 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, ORLANDO SERVICE CENTER, 400 W ROBINSON ST STE N302, ORLANDO FL328011759 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-07-12 |
| ANNUAL REPORT | 2023-04-28 |
| ANNUAL REPORT | 2022-04-30 |
| ANNUAL REPORT | 2021-05-01 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-04-27 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-04-30 |
| ANNUAL REPORT | 2016-04-26 |
| ANNUAL REPORT | 2015-04-30 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
