| Entity Name: | COUNTRY CLUB LIVING, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
COUNTRY CLUB LIVING, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 22 Jul 2003 (22 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 29 Nov 2021 (3 years ago) |
| Document Number: | P03000080320 |
| FEI/EIN Number |
200198480
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 16837 N. W. 91 STREET, HIALEAH, FL, 33018, US |
| Mail Address: | 16837 N. W. 91 STREET, HIALEAH, FL, 33018, US |
| ZIP code: | 33018 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063535854 | 2007-04-09 | 2023-01-27 | 16837 N. W. 91 CT., MIAMI LAKES, FL, 33018, US | 16837 N. W. 91 CT., MIAMI LAKES, FL, 33018, US | |||||||||||||||||||||||||||||||
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| Phone | +1 305-549-8657 |
| Fax | 3058169996 |
Authorized person
| Name | YENEY SUAREZ I |
| Role | OWNER |
| Phone | 7867158902 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL10449 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 142170100 |
| State | FL |
| Issuer | MEDICAID |
| Number | 689009100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SUAREZ YENEY | President | 16837 N. W. 91 Street, Hialeah, FL, 33018 |
| SUAREZ YENEY | Vice President | 16837 N. W. 91 Street, Hialeah, FL, 33018 |
| SUAREZ YENEY | Agent | 16837 N. W. 91 STREET, HIALEAH, FL, 33018 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000056812 | MIAMI LAKES RETIREMENT HOME | ACTIVE | 2018-05-08 | 2028-12-31 | - | 16837 NW 91 CT, MIAMI LAKES, FL, 33018 |
| G14000074048 | MIAMI LAKES RETIREMENT HOME | EXPIRED | 2014-07-17 | 2019-12-31 | - | 6791 ROYAL MELBOURNE DR, HIALEAH, FL, 33015 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2021-11-29 | - | - |
| CHANGE OF MAILING ADDRESS | 2021-11-29 | 16837 N. W. 91 STREET, HIALEAH, FL 33018 | - |
| REGISTERED AGENT NAME CHANGED | 2021-11-29 | SUAREZ, YENEY | - |
| REGISTERED AGENT ADDRESS CHANGED | 2021-11-29 | 16837 N. W. 91 STREET, HIALEAH, FL 33018 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2013-04-15 | 16837 N. W. 91 STREET, HIALEAH, FL 33018 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-31 |
| ANNUAL REPORT | 2023-01-19 |
| ANNUAL REPORT | 2022-01-19 |
| Amendment | 2021-11-29 |
| ANNUAL REPORT | 2021-04-20 |
| ANNUAL REPORT | 2020-06-09 |
| ANNUAL REPORT | 2019-04-24 |
| ANNUAL REPORT | 2018-04-03 |
| ANNUAL REPORT | 2017-03-29 |
| ANNUAL REPORT | 2016-04-14 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
