| Entity Name: | CHARLOTTE'S WAY ADC, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 01 Mar 2010 (15 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: | P10000018331 |
| FEI/EIN Number | 272047643 |
| Address: | 2538 BLACKSTONE COURT, JACKSONVILLE, FL, 32221, US |
| Mail Address: | 2538 BLACKSTONE COURT, JACKSONVILLE, FL, 32221, US |
| ZIP code: | 32221 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598160632 | 2014-10-31 | 2014-10-31 | 2538 BLACKSTONE CT, JACKSONVILLE, FL, 322214909, US | 2538 BLACKSTONE CT, JACKSONVILLE, FL, 322214909, US | |||||||||||||||||||||||
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| Phone | +1 904-365-7161 |
Authorized person
| Name | ERNESTINE APPLETON |
| Role | EXECUTIVE DIRECTOR |
| Phone | 9043657161 |
Taxonomy
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| License Number | 005627300 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 005627300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| APPLETON ERNESTINE | Agent | 2538 BLACKSTONE COURT, JACKSONVILLE, FL, 32221 |
| Name | Role | Address |
|---|---|---|
| APPLETON ERNESTINE | President | 2538 BLACKSTONE COURT, JACKSONVILLE, FL, 32221 |
| Name | Role | Address |
|---|---|---|
| APPLETON ERNESTINE | Director | 2538 BLACKSTONE COURT, JACKSONVILLE, FL, 32221 |
| Name | Role | Address |
|---|---|---|
| APPLETON ERNESTINE | Treasurer | 2538 BLACKSTONE COURT, JACKSONVILLE, FL, 32221 |
| Name | Role | Address |
|---|---|---|
| APPLETON ERNESTINE | Secretary | 2538 BLACKSTONE COURT, JACKSONVILLE, FL, 32221 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-05-01 |
| ANNUAL REPORT | 2012-05-01 |
| ANNUAL REPORT | 2011-03-08 |
| Domestic Profit | 2010-03-01 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
