| Entity Name: | CK GROUP HOME, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 18 Mar 2002 (23 years ago) |
| Document Number: | P02000029100 |
| FEI/EIN Number | 010642889 |
| Address: | 19431 NW 23RD CT, MIAMI GARDENS, FL, 33056, US |
| Mail Address: | 19431 NW 23RD CT, MIAMI GARDENS, FL, 33056, US |
| ZIP code: | 33056 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811258254 | 2012-06-01 | 2012-06-01 | 19431 NW 23RD CT, OPA LOCKA, FL, 330562653, US | 19431 NW 23RD CT, OPA LOCKA, FL, 330562653, US | |||||||||||||||||||||||
|
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| Phone | +1 305-788-1836 |
Authorized person
| Name | KATENA BROUSSARD |
| Role | OWNER |
| Phone | 3057881836 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | 230393 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | LICENSE |
| Number | 230393 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BROUSSARD KATENA | Agent | 19431 NW 23RD CT, OPA LOCKA, FL, 33055 |
| Name | Role | Address |
|---|---|---|
| BROUSSARD KATENA | President | 19431 NW 23RD CT, MIAMI GARDENS, FL, 33056 |
| Name | Role | Address |
|---|---|---|
| BROUSSARD KATENA | Secretary | 19431 NW 23RD CT, MIAMI GARDENS, FL, 33056 |
| Name | Role | Address |
|---|---|---|
| BROUSSARD KATENA | Treasurer | 19431 NW 23RD CT, MIAMI GARDENS, FL, 33056 |
| Name | Role | Address |
|---|---|---|
| BROUSSARD KATENA | Director | 19431 NW 23RD CT, MIAMI GARDENS, FL, 33056 |
| Name | Role | Address |
|---|---|---|
| GOODEN CHARNELL | Vice President | 19431 NW 23 COURT, MIAMI GARDENS, FL, 33056 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2017-05-15 | 19431 NW 23RD CT, MIAMI GARDENS, FL 33056 | No data |
| CHANGE OF MAILING ADDRESS | 2017-05-15 | 19431 NW 23RD CT, MIAMI GARDENS, FL 33056 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2004-04-16 | 19431 NW 23RD CT, OPA LOCKA, FL 33055 | No data |
| REGISTERED AGENT NAME CHANGED | 2003-01-16 | BROUSSARD, KATENA | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J17000162877 | TERMINATED | 1000000737756 | MIAMI-DADE | 2017-03-15 | 2027-03-24 | $ 2,125.44 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828 |
| J13001321653 | TERMINATED | 1000000464135 | MIAMI-DADE | 2013-08-15 | 2023-09-05 | $ 3,685.13 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828 |
| J12000168107 | TERMINATED | 1000000255582 | DADE | 2012-03-02 | 2022-03-07 | $ 1,434.18 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI NORTH SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-05 |
| ANNUAL REPORT | 2023-03-03 |
| ANNUAL REPORT | 2022-02-04 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-06-01 |
| ANNUAL REPORT | 2019-04-10 |
| ANNUAL REPORT | 2018-04-03 |
| ANNUAL REPORT | 2017-03-14 |
| ANNUAL REPORT | 2016-04-20 |
| ANNUAL REPORT | 2015-04-29 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
