| Entity Name: | BCJ RETIREMENT HOME, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 16 May 2005 (20 years ago) |
| Date of dissolution: | 25 Sep 2020 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 years ago) |
| Document Number: | P05000072156 |
| FEI/EIN Number | 721600401 |
| Address: | 4976 SW 7TH ST., MARGATE, FL, 33068 |
| Mail Address: | 4976 SW 7TH ST., MARGATE, FL, 33068 |
| ZIP code: | 33068 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467703017 | 2012-09-23 | 2012-09-23 | 4976 SW 7TH ST, MARGATE, FL, 330683137, US | 4976 SW 7TH ST, MARGATE, FL, 330683137, US | |||||||||||||||||||||||||
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| Phone | +1 954-254-0159 |
| Fax | 9549703881 |
Authorized person
| Name | MRS. BARBARA B WILSON |
| Role | ADMINISTRATOR |
| Phone | 9542540159 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL 10781 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 142691500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Vice President | Agent | 8533 NW 51st Pl, Coral Springs, FL, 33067 |
| Name | Role | Address |
|---|---|---|
| WAUGH-SANTOS JODI R | Vice President | 8533 NW 51st Pl, Coral Springs, FL, 33067 |
| Name | Role | Address |
|---|---|---|
| Wilson Barbara B | President | 4976 SW 7th Street, Margate, FL, 33068 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2013-04-08 | Vice President | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-04-08 | 8533 NW 51st Pl, Coral Springs, FL 33067 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-04-25 |
| ANNUAL REPORT | 2018-04-07 |
| ANNUAL REPORT | 2017-04-12 |
| ANNUAL REPORT | 2016-04-12 |
| ANNUAL REPORT | 2015-04-08 |
| ANNUAL REPORT | 2014-03-20 |
| ANNUAL REPORT | 2013-04-08 |
| ANNUAL REPORT | 2012-04-03 |
| ANNUAL REPORT | 2011-04-08 |
| ANNUAL REPORT | 2010-07-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
