| Entity Name: | AT HOME CARE ASSISTED LIVING FACILITY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 20 Jun 2011 (14 years ago) |
| Document Number: | P11000057153 |
| FEI/EIN Number | 452573334 |
| Mail Address: | 40105 French Rd, Lady Lake, FL, 32159, US |
| Address: | 42042 CHINABERRY STREET, EUSTIS, FL, 32736 |
| ZIP code: | 32736 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669759015 | 2011-11-14 | 2011-11-14 | 42042 CHINABERRY ST, EUSTIS, FL, 327368358, US | 42042 CHINABERRY ST, EUSTIS, FL, 327368358, US | |||||||||||||||||||
|
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| Phone | +1 407-948-0723 |
| Fax | 3212565193 |
Authorized person
| Name | MRS. KEISHA LATOYA GIST |
| Role | ADMINISTRATOR |
| Phone | 4079480723 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| Is Primary | Yes |
| Taxonomy Code | 311500000X - Alzheimer Center (Dementia Center) |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| GIST KEISHA L | Agent | 40105 French Rd, Lady Lake, FL, 32159 |
| Name | Role | Address |
|---|---|---|
| GIST KEISHA L | President | 42042 CHINABERRY STREET, EUSTIS, FL, 32736 |
| Name | Role | Address |
|---|---|---|
| GIST STANLEY X | Vice President | 42042 CHINABERRY STREET, EUSTIS, FL, 32736 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-04-30 | 42042 CHINABERRY STREET, EUSTIS, FL 32736 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-30 | 40105 French Rd, Lady Lake, FL 32159 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J24000721702 | ACTIVE | 1000001019264 | LAKE | 2024-11-05 | 2044-11-13 | $ 990.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, LEESBURG SERVICE CENTER, 900 N 14TH ST STE 201, LEESBURG FL347483829 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-30 |
| ANNUAL REPORT | 2022-03-04 |
| ANNUAL REPORT | 2021-07-15 |
| ANNUAL REPORT | 2020-06-03 |
| ANNUAL REPORT | 2019-04-16 |
| ANNUAL REPORT | 2018-04-09 |
| ANNUAL REPORT | 2017-01-24 |
| ANNUAL REPORT | 2016-03-10 |
| ANNUAL REPORT | 2015-04-12 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
