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  5. TOTAL CARE MANOR, INC.

TOTAL CARE MANOR, INC.

Company Details

Entity Name: TOTAL CARE MANOR, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 25 Feb 2003 (22 years ago)
Document Number: P03000022159
FEI/EIN Number 562321095
Address: 1490 NW 21ST STREET, FORT LAUDERDALE, FL, 33311
Mail Address: 1490 NW 21ST STREET, FORT LAUDERDALE, FL, 33311
ZIP code: 33311
County: Broward
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1871745265 2008-10-16 2020-08-26 1490 NW 21 STREET, FORT LAUDERDALE, FL, 33311, US 1490 NW 21 STREET, FORT LAUDERDALE, FL, 33311, US

Contacts
Phone +1 954-523-1543
Fax 9545270505

Authorized person
Name JASON KISSOONLAL
Role PRESIDENT
Phone 9545231543

Taxonomy
Taxonomy Code 3104A0625X - Assisted Living Facility (Mental Illness)
License Number AL8595
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 141923400
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TOTAL CARE MANOR, INC. 401(K) PLAN 2022 562321095 2023-07-11 TOTAL CARE MANOR, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 623000
Sponsor’s telephone number 9545231543
Plan sponsor’s address 1490 NW 21ST STREET, FT. LAUDERDALE, FL, 33311
TOTAL CARE MANOR, INC. 401(K) PLAN 2021 562321095 2022-10-01 TOTAL CARE MANOR, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 623000
Sponsor’s telephone number 9545231543
Plan sponsor’s address 1490 NW 21ST STREET, FT. LAUDERDALE, FL, 33311
TOTAL CARE MANOR, INC. 401(K) PLAN 2020 562321095 2021-07-11 TOTAL CARE MANOR, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 623000
Sponsor’s telephone number 9545231543
Plan sponsor’s address 1490 NW 21ST STREET, FT. LAUDERDALE, FL, 33311
TOTAL CARE MANOR, INC. 401(K) PLAN 2019 562321095 2020-07-05 TOTAL CARE MANOR, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 623000
Sponsor’s telephone number 9545231543
Plan sponsor’s address 1490 NW 21ST STREET, FT. LAUDERDALE, FL, 33311
TOTAL CARE MANOR, INC. 401(K) PLAN 2018 562321095 2019-04-21 TOTAL CARE MANOR, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 623000
Sponsor’s telephone number 9545231543
Plan sponsor’s address 1490 NW 21ST STREET, FT. LAUDERDALE, FL, 33311
TOTAL CARE MANOR, INC. 401(K) PLAN 2017 562321095 2018-06-30 TOTAL CARE MANOR, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 623000
Sponsor’s telephone number 9545231543
Plan sponsor’s address 1490 NW 21ST STREET, FT. LAUDERDALE, FL, 33311
TOTAL CARE MANOR, INC. 401(K) PLAN 2016 562321095 2017-03-20 TOTAL CARE MANOR, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 623000
Sponsor’s telephone number 9545231543
Plan sponsor’s address 1490 NW 21ST STREET, FT. LAUDERDALE, FL, 33311
TOTAL CARE MANOR, INC. 401(K) PLAN 2015 562321095 2016-05-30 TOTAL CARE MANOR, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 623000
Sponsor’s telephone number 9545231543
Plan sponsor’s address 1490 NW 21ST STREET, FT. LAUDERDALE, FL, 33311
TOTAL CARE MANOR, INC. 401(K) PLAN 2014 562321095 2015-08-29 TOTAL CARE MANOR, INC. 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 623000
Sponsor’s telephone number 9545231543
Plan sponsor’s address 1490 NW 21ST STREET, FT. LAUDERDALE, FL, 33311

Agent

Name Role Address
Kissoonlal Jason Agent 1490 NW 21ST STREET, FORT LAUDERDALE, FL, 33311

Officer

Name Role
TOTAL CARE MANOR, INC. Officer

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G19000113048 HORIZON RETIREMENT HOME ACTIVE 2019-10-17 2029-12-31 No data 1490 NW 21ST STREET, FORT LAUDERDALE, FL, 33311
G17000027082 HORIZON ALF ACTIVE 2017-03-14 2027-12-31 No data 1490 NW 21ST STREET, FORT LAUDERDALE, FL, 33311

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2024-04-20 Kissoonlal, Jason No data
CHANGE OF PRINCIPAL ADDRESS 2009-04-16 1490 NW 21ST STREET, FORT LAUDERDALE, FL 33311 No data
CHANGE OF MAILING ADDRESS 2009-04-16 1490 NW 21ST STREET, FORT LAUDERDALE, FL 33311 No data
REGISTERED AGENT ADDRESS CHANGED 2009-04-16 1490 NW 21ST STREET, FORT LAUDERDALE, FL 33311 No data

Documents

Name Date
ANNUAL REPORT 2024-04-20
ANNUAL REPORT 2023-04-18
ANNUAL REPORT 2022-04-06
ANNUAL REPORT 2021-04-20
ANNUAL REPORT 2020-06-09
ANNUAL REPORT 2019-04-25
ANNUAL REPORT 2018-04-24
ANNUAL REPORT 2017-04-25
ANNUAL REPORT 2016-04-18
ANNUAL REPORT 2015-04-22

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
8124867308 2020-05-01 0455 PPP 1490 NW 21ST ST, FORT LAUDERDALE, FL, 33311-3522
Loan Status Date 2021-04-16
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 62504
Loan Approval Amount (current) 62504
Undisbursed Amount 0
Franchise Name -
Lender Location ID 9551
Servicing Lender Name Bank of America, National Association
Servicing Lender Address 100 N Tryon St, Ste 170, CHARLOTTE, NC, 28202-4024
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address FORT LAUDERDALE, BROWARD, FL, 33311-3522
Project Congressional District FL-20
Number of Employees 10
NAICS code 621610
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 9551
Originating Lender Name Bank of America, National Association
Originating Lender Address CHARLOTTE, NC
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 63016.02
Forgiveness Paid Date 2021-02-25

Related by officers

Kissoonlal Jason

PALMS VILLA RETIREMENT HOME, INC.

Related by address

No related companies by address

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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