| Entity Name: | RENAISSANCE SUPPORTIVE SERVICES INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 14 Nov 2005 (19 years ago) |
| Date of dissolution: | 23 Sep 2011 (13 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2011 (13 years ago) |
| Document Number: | P05000150529 |
| FEI/EIN Number | 203785876 |
| Address: | 10213 RISING MIST LANE, JACKSONVILLE, FL, 32221 |
| Mail Address: | 10213 RISING MIST LANE, JACKSONVILLE, FL, 32221 |
| ZIP code: | 32221 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457596678 | 2008-12-03 | 2008-12-03 | 10213 RISING MIST LN, JACKSONVILLE, FL, 322213006, US | 10213 RISING MIST LN, JACKSONVILLE, FL, 322213006, US | |||||||||||||||||||||||
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| Phone | +1 904-786-6486 |
Authorized person
| Name | MRS. LATRESE CURRY HARRISON |
| Role | OWNER |
| Phone | 9047866486 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| License Number | 690575796 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 690575796 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HARRISON LATRESE C | Agent | 10213 RISING MIST LANE, JACKSONVILLE, FL, 32221 |
| Name | Role | Address |
|---|---|---|
| HARRISON LATRESE C | President | 10213 RISING MIST LANE, JACKSONVILLE, FL, 32221 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| CANCEL ADM DISS/REV | 2009-11-10 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2009-11-10 | 10213 RISING MIST LANE, JACKSONVILLE, FL 32221 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2010-04-30 |
| CORAPREIWP | 2009-11-10 |
| Domestic Profit | 2005-11-14 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
