| Entity Name: | TENDER LOVING CARE ASSISTED LIVING FACILITY OF FLORIDA, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 04 Nov 2002 (22 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 01 Oct 2010 (14 years ago) |
| Document Number: | P02000118582 |
| FEI/EIN Number | 161647414 |
| Address: | 3100 SW 79TH AVE, MIAMI, FL, 33155 |
| Mail Address: | 3100 SW 79TH AVE, MIAMI, FL, 33155 |
| ZIP code: | 33155 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194936237 | 2007-05-24 | 2023-01-03 | 3100 SW 79TH AVE, MIAMI, FL, 331552511, US | 3100 SW 79TH AVE, MIAMI, FL, 331552511, US | |||||||||||||||||||||||||||||||
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| Phone | +1 305-264-9138 |
| Fax | 3052251289 |
Authorized person
| Name | DAMARYS CRUZ |
| Role | OWNER/ADMINISTRATOR |
| Phone | 3053323057 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL 10309 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 142285500 |
| State | FL |
| Issuer | MEDICAID |
| Number | 115629500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| NUNEZ JAVIER | Agent | 3100 SW 79TH AVE, MIAMI, FL, 33155 |
| Name | Role | Address |
|---|---|---|
| CRUZ DAMARYS | President | 3100 SW 79TH AVE, MIAMI, FL, 33155 |
| Name | Role | Address |
|---|---|---|
| NUNEZ JAVIER | Vice President | 3100 SW 79TH AVE, MIAMI, FL, 33155 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000110786 | TENDER LOVING CARE ALF. | ACTIVE | 2023-09-11 | 2028-12-31 | No data | 3100 SW 79 AVE, MIAMI, FL, 33155 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2010-10-01 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2005-02-07 | NUNEZ, JAVIER | No data |
| AMENDMENT | 2004-11-08 | No data | No data |
| REINSTATEMENT | 2003-11-20 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2003-09-19 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-24 |
| ANNUAL REPORT | 2023-04-18 |
| ANNUAL REPORT | 2022-04-11 |
| ANNUAL REPORT | 2021-05-03 |
| ANNUAL REPORT | 2020-05-03 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-04-14 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-04-11 |
| ANNUAL REPORT | 2015-03-19 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
