| Entity Name: | MARION PROVIDER CARE SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 02 Oct 2007 (17 years ago) |
| Date of dissolution: | 26 Sep 2014 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (10 years ago) |
| Document Number: | P07000108319 |
| FEI/EIN Number | 900389467 |
| Address: | 1010 E ADAMS, 105, JACKSONVILLE, FL, 32202 |
| Mail Address: | 1010 E ADAMS, 105, JACKSONVILLE, FL, 32202 |
| ZIP code: | 32202 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043471857 | 2008-06-24 | 2008-06-24 | 1010 E ADAMS ST, SUITE 105, JACKSONVILLE, FL, 322021902, US | 1010 E ADAMS ST, SUITE 105, JACKSONVILLE, FL, 322021902, US | |||||||||||||||||||||||||||
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| Phone | +1 904-379-1528 |
| Fax | 9042120615 |
Authorized person
| Name | MS. BELLISSIA MARION PANDY |
| Role | OWNER/MANAGER |
| Phone | 9045375718 |
Taxonomy
| Taxonomy Code | 251C00000X - Developmentally Disabled Services Day Training Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 687986198 |
| State | FL |
| Issuer | MEDICAID |
| Number | 687986196 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ANDERSON ANGELA | Agent | 1010 E ADAMS STE 105, JACKSONVILLE, FL, 32204 |
| Name | Role | Address |
|---|---|---|
| PANDY BELLISSIA | Director | 10318 PIEDMONT RD., JACKSONVILLE, FL, 32218 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2011-04-24 | 1010 E ADAMS, 105, JACKSONVILLE, FL 32202 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-05-02 | 1010 E ADAMS, 105, JACKSONVILLE, FL 32202 | No data |
| REGISTERED AGENT NAME CHANGED | 2008-05-02 | ANDERSON, ANGELA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-05-02 | 1010 E ADAMS STE 105, JACKSONVILLE, FL 32204 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-04-20 |
| ANNUAL REPORT | 2012-04-15 |
| ANNUAL REPORT | 2011-04-24 |
| ANNUAL REPORT | 2010-03-08 |
| ANNUAL REPORT | 2009-04-05 |
| ANNUAL REPORT | 2008-05-02 |
| Domestic Profit | 2007-10-02 |
Date of last update: 03 Jan 2025
Sources: Florida Department of State
