| Entity Name: | CRESTWOOD NURSING CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
CRESTWOOD NURSING CENTER, 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: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 19 Jul 2005 (20 years ago) |
| Date of dissolution: | 22 Sep 2023 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (2 years ago) |
| Document Number: | P05000100898 |
| FEI/EIN Number |
510548422
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 995 Canton St., Roswell, GA, 30075, US |
| Mail Address: | 995 Canton St., Roswell, GA, 30075, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023010071 | 2005-08-10 | 2019-07-18 | 995 CANTON ST STE 100, ROSWELL, GA, 300754240, US | 501 S PALM AVE, PALATKA, FL, 321774147, US | |||||||||||||||||||||
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| Fax | 3863251531 |
| Phone | +1 386-328-1472 |
Authorized person
| Name | ROBERT HAGAN |
| Role | PRESIDENT |
| Phone | 7709934000 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 031227400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| REGISTERED AGENTS INC | Agent | - |
| HAGAN ROBERT W | Chief Executive Officer | 995 CANTON STREET, ROSWELL, GA, 30075 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | - | - |
| CHANGE OF MAILING ADDRESS | 2022-04-20 | 995 Canton St., Suite 100, Roswell, GA 30075 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-20 | 995 Canton St., Suite 100, Roswell, GA 30075 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2019-03-25 | 7901 4TH STREET NORTH, SUITE 300, ST.PETERSBURG, FL 33702 | - |
| REGISTERED AGENT NAME CHANGED | 2014-04-14 | Registered Agents Inc. | - |
| CANCEL ADM DISS/REV | 2006-11-03 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | - | - |
| ARTICLES OF CORRECTION | 2005-07-28 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-04-20 |
| ANNUAL REPORT | 2021-04-14 |
| ANNUAL REPORT | 2020-06-11 |
| ANNUAL REPORT | 2019-04-12 |
| ANNUAL REPORT | 2018-03-09 |
| ANNUAL REPORT | 2017-04-05 |
| ANNUAL REPORT | 2016-03-29 |
| ANNUAL REPORT | 2015-04-08 |
| ANNUAL REPORT | 2014-04-14 |
| ANNUAL REPORT | 2013-04-23 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1856587300 | 2020-04-28 | 0491 | PPP | 501 S Palm Ave, PALATKA, FL, 32177 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5506068607 | 2021-03-20 | 0491 | PPS | 501 S Palm Ave, Palatka, FL, 32177-4147 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 03 Apr 2025
Sources: Florida Department of State
