| Entity Name: | TLAY HEALTHCARE SERVICES INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 24 Apr 2006 (19 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 13 Nov 2009 (15 years ago) |
| Document Number: | P06000058297 |
| FEI/EIN Number | 550917731 |
| Address: | 2802 North 5th Street, SAINT AUGUSTINE, FL, 32084, US |
| Mail Address: | 2802 North 5th Street, SAINT AUGUSTINE, FL, 32084, US |
| ZIP code: | 32084 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386835874 | 2007-08-08 | 2015-12-01 | 2802 N 5TH ST, ST AUGUSTINE, FL, 320841837, US | 2802 N 5TH ST, ST AUGUSTINE, FL, 320841837, US | |||||||||||||||||||||
|
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| Phone | +1 904-794-7601 |
| Fax | 9047947602 |
Authorized person
| Name | DR. IMELDA AZUOMA NWOGA |
| Role | ADMINISTRATOR |
| Phone | 9047947601 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 692666500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| IMELDA NWOGA | Agent | 2802 North 5th Street, SAINT AUGUSTINE, FL, 32084 |
| Name | Role | Address |
|---|---|---|
| NWOGA IMELDA ADr. | Administrator | 2802 North 5th Street, SAINT AUGUSTINE, FL, 32084 |
| Name | Role | Address |
|---|---|---|
| NWOGA IMELDA ADr. | Chairman | 2802 North 5th Street, SAINT AUGUSTINE, FL, 32084 |
| Name | Role | Address |
|---|---|---|
| NWOGA JUDE CDr. | Treasurer | 2802 North 5th Street, SAINT AUGUSTINE, FL, 32084 |
| Name | Role | Address |
|---|---|---|
| Nau Nwetamachi LDr. | Secretary | 2802 North 5th Street, SAINT AUGUSTINE, FL, 32084 |
| Name | Role | Address |
|---|---|---|
| NWOGA UGOCHI D | Asst | 2802 North 5th Street, SAINT AUGUSTINE, FL, 32084 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-01-10 | IMELDA, NWOGA | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-01-05 | 2802 North 5th Street, SAINT AUGUSTINE, FL 32084 | No data |
| CHANGE OF MAILING ADDRESS | 2015-01-05 | 2802 North 5th Street, SAINT AUGUSTINE, FL 32084 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-01-05 | 2802 North 5th Street, SAINT AUGUSTINE, FL 32084 | No data |
| AMENDMENT | 2009-11-13 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-19 |
| ANNUAL REPORT | 2023-01-10 |
| ANNUAL REPORT | 2022-01-21 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-01-13 |
| AMENDED ANNUAL REPORT | 2019-09-05 |
| ANNUAL REPORT | 2019-01-16 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-06-05 |
| ANNUAL REPORT | 2016-03-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
