| Entity Name: | SAMARINO RETIREMENT HOME, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 13 Oct 2009 (15 years ago) |
| Document Number: | P09000084559 |
| FEI/EIN Number | 271116067 |
| Address: | 1517 SUNDOWN LANE, CLERMONT, FL, 34711 |
| Mail Address: | 1517 SUNDOWN LANE, CLERMONT, FL, 34711 |
| ZIP code: | 34711 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043878473 | 2019-05-31 | 2019-05-31 | 1517 SUNDOWN LN, CLERMONT, FL, 347112793, US | 850 N HART BLVD, ORLANDO, FL, 328186836, US | |||||||||||||||||||
|
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| Phone | +1 352-217-6708 |
Authorized person
| Name | LIGAYA GATCHALIAN-VALEROS |
| Role | ADMINISTRATOR |
| Phone | 3522176708 |
Taxonomy
| Taxonomy Code | 3104A0630X - Assisted Living Facility (Behavioral Disturbances) |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 102130900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Gatchalian-Valeros Ligaya | Agent | 1517 Sundown Lane, CLERMONT, FL, 34711 |
| Name | Role | Address |
|---|---|---|
| VALEROS DOMINGO G | President | 1517 SUNDOWN LANE, CLERMONT, FL, 34711 |
| Name | Role | Address |
|---|---|---|
| GATCHALIAN-VALEROS LIGAYA | Vice President | 1517 SUNDOWN LANE, CLERMONT, FL, 34711 |
| Name | Role | Address |
|---|---|---|
| VALEROS DOMINGO | Treasurer | 1517 SUNDOWN LANE, CLERMONT, FL, 34711 |
| Name | Role | Address |
|---|---|---|
| GATCHALIAN-VALEROS LIGAYA | Secretary | 1517 SUNDOWN LANE, CLERMONT, FL, 34711 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000029437 | SUNRISE RETIREMENT HOME | ACTIVE | 2019-03-04 | 2029-12-31 | No data | 850 N HART BLVD, ORLANDO, FL, 32818 |
| G10000055587 | LGV WELLNESS CENTER | EXPIRED | 2010-06-17 | 2015-12-31 | No data | 1517 SUNDOWN LANE, CLERMONT, FL, 34711 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2018-04-30 | Gatchalian-Valeros, Ligaya | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-04-30 | 1517 Sundown Lane, CLERMONT, FL 34711 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-07-25 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-04-12 |
| ANNUAL REPORT | 2021-05-05 |
| ANNUAL REPORT | 2020-06-29 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-04-30 |
| ANNUAL REPORT | 2016-04-29 |
| ANNUAL REPORT | 2015-04-30 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
