| Entity Name: | VILLA OF KINGS & QUEENS OF DELRAY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 05 Jan 2007 (18 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | P07000002408 |
| FEI/EIN Number | 208235841 |
| Address: | 13415 BARWICK ROAD, DELRAY BEACH, FL, 33445, US |
| Mail Address: | 13415 Barwick road, DELRAY BEACH, FL, 33445, US |
| ZIP code: | 33445 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255573630 | 2009-03-31 | 2009-12-18 | PO BOX 581, NEW YORK, NY, 101850581, US | 13415 BARWICK RD, DELRAY BEACH, FL, 334451209, US | |||||||||||||||||||||||||
|
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| Phone | +1 561-450-8551 |
| Fax | 5614983870 |
Authorized person
| Name | MR. EDMOND ETIENNE |
| Role | VICE PRESIDENT |
| Phone | 5614508551 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL11308 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000089300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ETIENNE EDMOND | Agent | 13415 BARWICK ROAD, DELRAY BEACH, FL, 33445 |
| Name | Role | Address |
|---|---|---|
| ETIENNE EDMOND | Chief Executive Officer | 13415 BARWICK ROAD, DELRAY BEACH, FL, 33445 |
| Name | Role | Address |
|---|---|---|
| ETIENNNE KETTLY | President | 13415 BARWICK ROAD, DELRAY BEACH, FL, 33445 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2018-02-22 | 13415 BARWICK ROAD, DELRAY BEACH, FL 33445 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-04-05 | 13415 BARWICK ROAD, DELRAY BEACH, FL 33445 | No data |
| AMENDMENT AND NAME CHANGE | 2007-07-09 | VILLA OF KINGS & QUEENS OF DELRAY, INC. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-02-03 |
| ANNUAL REPORT | 2020-03-12 |
| ANNUAL REPORT | 2019-02-22 |
| ANNUAL REPORT | 2018-02-22 |
| ANNUAL REPORT | 2017-01-07 |
| ANNUAL REPORT | 2016-01-27 |
| ANNUAL REPORT | 2015-04-10 |
| ANNUAL REPORT | 2014-03-19 |
| ANNUAL REPORT | 2013-01-29 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
