| Entity Name: | KINDHEARTED ASSISTED LIVING FACILITY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 28 Dec 2007 (17 years ago) |
| Date of dissolution: | 04 Aug 2020 (5 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 04 Aug 2020 (5 years ago) |
| Document Number: | P07000135239 |
| FEI/EIN Number | 943441389 |
| Address: | 2815 CLEVELAND HEIGHTS BLVD, LAKELAND, FL, 33803 |
| Mail Address: | 2459 Twin lake View Rd, Winter Haven, FL, 33881, US |
| ZIP code: | 33803 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922396431 | 2011-07-18 | 2015-04-16 | 2815 CLEVELAND HEIGHTS BLVD, LAKELAND, FL, 338034107, US | 2815 CLEVELAND HEIGHTS BLVD, LAKELAND, FL, 338034107, US | |||||||||||||||||||||||||||
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| Fax | 8635783017 |
| Phone | +1 863-248-3038 |
| Fax | 8635784800 |
Authorized person
| Name | MRS. YOLENE MILHOMME |
| Role | ADMINISTRATOR |
| Phone | 8635785800 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL11530 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000881700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MILHOMME JEAN ASr. | Agent | 2459 Twin Lake View Road, Winter Haven, FL, 33881 |
| Name | Role | Address |
|---|---|---|
| MILHOMME JEAN S | Director | 2459 Twin Lake View Road, Winter Haven, FL, 33881 |
| Name | Role | Address |
|---|---|---|
| YOLENE MILHOMME S | Admi | 2459 Twin Lake View Road, Winter Haven, FL, 33881 |
| Name | Role | Address |
|---|---|---|
| MILHOMME Jean ASr. | Asst | 2459 Twin Lake View Road, Winter Haven, FL, 33881 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2020-08-04 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-07-03 | 2459 Twin Lake View Road, Winter Haven, FL 33881 | No data |
| CHANGE OF MAILING ADDRESS | 2019-07-03 | 2815 CLEVELAND HEIGHTS BLVD, LAKELAND, FL 33803 | No data |
| REGISTERED AGENT NAME CHANGED | 2019-07-03 | MILHOMME, JEAN A, Sr. | No data |
| REINSTATEMENT | 2015-11-01 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| CANCEL ADM DISS/REV | 2010-04-07 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-04-07 | 2815 CLEVELAND HEIGHTS BLVD, LAKELAND, FL 33803 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J13000767146 | TERMINATED | 1000000492977 | POLK | 2013-04-11 | 2033-04-17 | $ 465.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, LAKELAND SERVICE CENTER, 115 S MISSOURI AVE STE 202, LAKELAND FL338154644 |
| J12001012486 | TERMINATED | 1000000423714 | POLK | 2012-11-26 | 2032-12-14 | $ 300.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, LAKELAND SERVICE CENTER, 115 S MISSOURI AVE STE 202, LAKELAND FL338154644 |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2020-08-04 |
| ANNUAL REPORT | 2019-07-03 |
| ANNUAL REPORT | 2018-04-27 |
| ANNUAL REPORT | 2017-02-10 |
| ANNUAL REPORT | 2016-05-02 |
| REINSTATEMENT | 2015-11-01 |
| ANNUAL REPORT | 2014-05-08 |
| ANNUAL REPORT | 2013-03-01 |
| ANNUAL REPORT | 2012-04-10 |
| ANNUAL REPORT | 2011-04-26 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
