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  5. MIHOM HEALTHCARE, INC.

MIHOM HEALTHCARE, INC.

Company Details

Entity Name: MIHOM HEALTHCARE, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 02 Dec 2003 (21 years ago)
Last Event: AMENDMENT
Event Date Filed: 04 May 2023 (2 years ago)
Document Number: P03000143635
FEI/EIN Number 611461776
Address: 2100 SE HILLMOOR DRIVE, SUITE 102, PORT SAINT LUCIE, FL, 34952, US
Mail Address: 2100 SE HILLMOOR DRIVE, SUITE 102, PORT SAINT LUCIE, FL, 34952, US
ZIP code: 34952
County: St. Lucie
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1730235276 2007-01-26 2017-10-25 2100 SE HILLMOOR DR, SUITE102, PORT ST LUCIE, FL, 349528057, US 2100 SE HILLMOOR DR STE 102, PORT ST LUCIE, FL, 349528057, US

Contacts
Phone +1 772-873-3838
Fax 7728733839

Authorized person
Name MRS. SUSAN F. PERRY
Role ADMINISTRATOR
Phone 7728733838

Taxonomy
Taxonomy Code 251E00000X - Home Health Agency
License Number 299991919
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MIHOM HEALTHCARE, INC. RETIREMENT TRUST 2023 611461776 2024-06-14 MIHOM HEALTHCARE, INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621610
Sponsor’s telephone number 7728733838
Plan sponsor’s address 2100 SE HILLMOOR DRIVE, SUITE 102, PORT ST. LUCIE, FL, 34952

Signature of
Role Plan administrator
Date 2024-06-14
Name of individual signing JOSEPH ZIMMERMAN
Valid signature Filed with authorized/valid electronic signature
MIHOM HEALTHCARE, INC. RETIREMENT TRUST 2022 611461776 2023-07-10 MIHOM HEALTHCARE, INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621610
Sponsor’s telephone number 7728733838
Plan sponsor’s address 2100 SE HILLMOOR DRIVE, SUITE 102, PORT ST. LUCIE, FL, 34952

Signature of
Role Plan administrator
Date 2023-07-10
Name of individual signing SUSAN F. PERRY
Valid signature Filed with authorized/valid electronic signature
MIHOM HEALTHCARE, INC. RETIREMENT TRUST 2021 611461776 2022-09-07 MIHOM HEALTHCARE, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621610
Sponsor’s telephone number 7728733838
Plan sponsor’s address 2100 SE HILLMOOR DRIVE, SUITE 102, PORT ST. LUCIE, FL, 34952

Signature of
Role Plan administrator
Date 2022-09-07
Name of individual signing SUSAN F. PERRY
Valid signature Filed with authorized/valid electronic signature
MIHOM HEALTHCARE, INC. RETIREMENT TRUST 2020 611461776 2021-09-01 MIHOM HEALTHCARE, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621610
Sponsor’s telephone number 7728733838
Plan sponsor’s address 2100 SE HILLMOOR DRIVE, SUITE 102, PORT ST. LUCIE, FL, 34952

Signature of
Role Plan administrator
Date 2021-09-01
Name of individual signing SUSAN F. PERRY
Valid signature Filed with authorized/valid electronic signature
MIHOM HEALTHCARE, INC. RETIREMENT TRUST 2019 611461776 2020-07-09 MIHOM HEALTHCARE, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621610
Sponsor’s telephone number 7728733838
Plan sponsor’s address 2100 SE HILLMOOR DRIVE, SUITE 102, PORT ST. LUCIE, FL, 34952

Plan administrator’s name and address
Administrator’s EIN 611461776
Plan administrator’s name MIHOM HEALTHCARE, INC.
Plan administrator’s address 2100 SE HILLMOOR DRIVE, SUITE 102, PORT ST. LUCIE, FL, 34952
Administrator’s telephone number 7728733838

Signature of
Role Plan administrator
Date 2020-07-09
Name of individual signing SUSAN F. PERRY
Valid signature Filed with authorized/valid electronic signature
MIHOM HEALTHCARE, INC. RETIREMENT TRUST 2018 611461776 2019-09-05 MIHOM HEALTHCARE, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621610
Sponsor’s telephone number 7728733838
Plan sponsor’s address 2100 SE HILLMOOR DRIVE, SUITE 102, PORT ST. LUCIE, FL, 34952

Plan administrator’s name and address
Administrator’s EIN 611461776
Plan administrator’s name MIHOM HEALTHCARE, INC.
Plan administrator’s address 2100 SE HILLMOOR DRIVE, SUITE 102, PORT ST. LUCIE, FL, 34952
Administrator’s telephone number 7728733838

Signature of
Role Plan administrator
Date 2019-09-05
Name of individual signing SUSAN F. PERRY
Valid signature Filed with authorized/valid electronic signature
MIHOM HEALTHCARE, INC. RETIREMENT TRUST 2017 611461776 2018-10-10 MIHOM HEALTHCARE, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621610
Sponsor’s telephone number 7728733838
Plan sponsor’s address 2100 SE HILLMOOR DRIVE, SUITE 102, PORT ST. LUCIE, FL, 34952

Plan administrator’s name and address
Administrator’s EIN 611461776
Plan administrator’s name MIHOM HEALTHCARE, INC.
Plan administrator’s address 2100 SE HILLMOOR DRIVE, SUITE 102, PORT ST. LUCIE, FL, 34952
Administrator’s telephone number 7728733838

Signature of
Role Plan administrator
Date 2018-10-10
Name of individual signing SUSAN F. PERRY
Valid signature Filed with authorized/valid electronic signature
MIHOM HEALTHCARE, INC. RETIREMENT TRUST 2016 611461776 2017-07-14 MIHOM HEALTHCARE, INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621610
Sponsor’s telephone number 7728733838
Plan sponsor’s address 2100 SE HILLMOOR DRIVE, SUITE 102, PORT ST. LUCIE, FL, 34952

Plan administrator’s name and address
Administrator’s EIN 611461776
Plan administrator’s name MIHOM HEALTHCARE, INC.
Plan administrator’s address 2100 SE HILLMOOR DRIVE, SUITE 102, PORT ST. LUCIE, FL, 34952
Administrator’s telephone number 7728733838

Signature of
Role Plan administrator
Date 2017-07-14
Name of individual signing SUSAN F. PERRY
Valid signature Filed with authorized/valid electronic signature
MIHOM HEALTHCARE, INC. RETIREMENT TRUST 2015 611461776 2016-07-06 MIHOM HEALTHCARE, INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621610
Sponsor’s telephone number 7728733838
Plan sponsor’s address 2100 SE HILLMOOR DRIVE, SUITE 102, PORT ST. LUCIE, FL, 34952

Plan administrator’s name and address
Administrator’s EIN 611461776
Plan administrator’s name MIHOM HEALTHCARE, INC.
Plan administrator’s address 2100 SE HILLMOOR DRIVE, SUITE 102, PORT ST. LUCIE, FL, 34952
Administrator’s telephone number 7728733838

Signature of
Role Plan administrator
Date 2016-07-06
Name of individual signing SUSAN F. PERRY
Valid signature Filed with authorized/valid electronic signature
MIHOM HEALTHCARE, INC. RETIREMENT TRUST 2014 611461776 2015-08-04 MIHOM HEALTHCARE, INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621610
Sponsor’s telephone number 7728733838
Plan sponsor’s address 2100 SE HILLMOOR DRIVE SUITE 102, PORT ST. LUCIE, FL, 34952

Plan administrator’s name and address
Administrator’s EIN 611461776
Plan administrator’s name MIHOM HEALTHCARE, INC.
Plan administrator’s address 2100 SE HILLMOOR DRIVE, SUITE 102, PORT ST. LUCIE, FL, 34952
Administrator’s telephone number 7728733838

Signature of
Role Plan administrator
Date 2015-08-04
Name of individual signing SUSAN F. PERRY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
LIEDY LESLIE Agent 3019 N SHANNON LAKES DRIVE, TALLAHASSEE, FL, 33209

President

Name Role Address
SPITZER CHESKEL President 2100 SE HILLMOOR DRIVE, PORT SAINT LUCIE, FL, 34952

Director

Name Role Address
SPITZER CHESKEL Director 2100 SE HILLMOOR DRIVE, PORT SAINT LUCIE, FL, 34952

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G23000142683 PARX HOME HEALTH CARE ACTIVE 2023-11-22 2028-12-31 No data 2100 SE HILLMOOR DRIVE, SUITE 102, PORT SAINT LUCIE, FL, 34952

Events

Event Type Filed Date Value Description
AMENDMENT 2023-05-04 No data No data
REGISTERED AGENT NAME CHANGED 2023-05-04 LIEDY, LESLIE No data
REGISTERED AGENT ADDRESS CHANGED 2023-05-04 3019 N SHANNON LAKES DRIVE, 1000 GATES AVE, 4TH FL, SUITE 204, TALLAHASSEE, FL 33209 No data
CHANGE OF PRINCIPAL ADDRESS 2023-05-02 2100 SE HILLMOOR DRIVE, SUITE 102, PORT SAINT LUCIE, FL 34952 No data
CHANGE OF MAILING ADDRESS 2023-05-02 2100 SE HILLMOOR DRIVE, SUITE 102, PORT SAINT LUCIE, FL 34952 No data

Documents

Name Date
ANNUAL REPORT 2024-02-21
Amendment 2023-05-04
ANNUAL REPORT 2023-03-10
ANNUAL REPORT 2022-04-13
ANNUAL REPORT 2021-04-07
ANNUAL REPORT 2020-02-17
ANNUAL REPORT 2019-02-25
ANNUAL REPORT 2018-03-15
ANNUAL REPORT 2017-03-15
ANNUAL REPORT 2016-04-21

Related by officers

SPITZER CHESKEL

SELWYN ST. LOUIS, INC. MIHOM PROPERTY HOLDINGS, LLC SENIOR FOCUS HEALTH SYSTEMS, L.L.C. CITADEL HOME HEALTH CARE LLC PARX HEALTH HOLDINGS LLC PARX EXP HOLDINGS LLC PARX EXP LLC PARX MIHOM ACQUISITION LLC MIHOM REALTY LLC PARX ALLEN ACQUISITION LLC

LIEDY LESLIE

PARX CC ACQUISITION, LLC

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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