| Entity Name: | CASA BONITA ASSISTED LIVING FACILITY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 20 Jun 2011 (14 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: | P11000057141 |
| FEI/EIN Number | 453517894 |
| Address: | 931 NE 17TH TERRACE, HOMESTEAD, FL, 33033 |
| Mail Address: | 931 NE 17TH TERRACE, HOMESTEAD, FL, 33033 |
| ZIP code: | 33033 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497024699 | 2011-12-19 | 2011-12-19 | 931 NE 17TH TER, HOMESTEAD, FL, 330334633, US | 931 NE 17TH TER, HOMESTEAD, FL, 330334633, US | |||||||||||||||||||||||||
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| Phone | +1 305-878-4535 |
| Fax | 1305433818 |
Authorized person
| Name | HAYDEE MAYOR |
| Role | OWNER |
| Phone | 3058784535 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL11281 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 004223700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MAYOR HAYDEE | Agent | 14207 SW 116TH TERRACE, MIAMI, FLORIDA, FL, 33186 |
| Name | Role | Address |
|---|---|---|
| MAYOR HAYDEE | President | 14207 S,W, 116 TERRACE, MIAMI, FL, 33186 |
| Name | Role | Address |
|---|---|---|
| MAYOR HAYDEE | Treasurer | 14207 S,W, 116 TERRACE, MIAMI, FL, 33186 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-09-07 | 931 NE 17TH TERRACE, HOMESTEAD, FL 33033 | No data |
| CHANGE OF MAILING ADDRESS | 2011-09-07 | 931 NE 17TH TERRACE, HOMESTEAD, FL 33033 | No data |
| REGISTERED AGENT NAME CHANGED | 2011-09-07 | MAYOR, HAYDEE | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-09-07 | 14207 SW 116TH TERRACE, MIAMI, FLORIDA, FL 33186 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-02-08 |
| ANNUAL REPORT | 2012-04-25 |
| Reg. Agent Change | 2011-09-07 |
| Off/Dir Resignation | 2011-08-23 |
| Domestic Profit | 2011-06-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
