| Entity Name: | TENDER AT HEART ASSISTED LIVING FACILITY INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 08 May 2012 (13 years ago) |
| Document Number: | P12000042860 |
| FEI/EIN Number | 45-5015105 |
| Address: | 1773 HAYS STREET, PALM BAY, FL, 32907 |
| Mail Address: | 1773 HAYS STREET, PALM BAY, FL, 32907 |
| ZIP code: | 32907 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194068221 | 2013-03-27 | 2013-03-27 | 1773 HAYS ST NW, PALM BAY, FL, 329077115, US | 1773 HAYS ST NW, PALM BAY, FL, 329077115, US | |||||||||||||||||||||||||
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| Phone | +1 321-327-2936 |
| Fax | 3218214626 |
Authorized person
| Name | JENNY-ANN JOHNSON |
| Role | ADMINISTRATOR |
| Phone | 3213272936 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | 12260 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 006637200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Johnson Jenny-Ann | Agent | 1773 HAYS STREET, PALM BAY, FL, 32907 |
| Name | Role | Address |
|---|---|---|
| Johnson Kenrick | Vice President | 1773 HAYS STREET, PALM BAY, FL, 32907 |
| Name | Role | Address |
|---|---|---|
| Johnson Jenny-Ann | President | 1773 HAYS STREET, PALM BAY, FL, 32907 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2014-04-08 | Johnson, Jenny-Ann | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-17 |
| ANNUAL REPORT | 2023-04-10 |
| ANNUAL REPORT | 2022-03-27 |
| ANNUAL REPORT | 2021-03-13 |
| ANNUAL REPORT | 2020-04-09 |
| ANNUAL REPORT | 2019-05-26 |
| ANNUAL REPORT | 2018-04-27 |
| ANNUAL REPORT | 2017-04-09 |
| ANNUAL REPORT | 2016-04-11 |
| ANNUAL REPORT | 2015-04-11 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
