| Entity Name: | BLACK CREEK SUPPORTS AND SERVICES INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
BLACK CREEK SUPPORTS AND SERVICES INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 16 Oct 2012 (13 years ago) |
| Date of dissolution: | 22 Sep 2023 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (2 years ago) |
| Document Number: | P12000087201 |
| FEI/EIN Number |
46-1200718
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 225 COLLEGE DR#66146, ORANGE PARK, FL, 32065, US |
| Mail Address: | 225 COLLEGE DR#66146, ORANGE PARK, FL, 32065, US |
| ZIP code: | 32065 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902214174 | 2014-07-31 | 2014-07-31 | 1700 LISMORE CT, MIDDLEBURG, FL, 320686703, US | 1700 LISMORE CT, MIDDLEBURG, FL, 320686703, US | |||||||||||||||||||||||||
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| Phone | +1 904-449-2699 |
| Fax | 9043752019 |
Authorized person
| Name | SHIELA BRYANT BUTLER |
| Role | PRESIDENT |
| Phone | 9044492699 |
Taxonomy
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| License Number | 232967 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 008143400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BUTLER SHIELA B | Officer | 225 COLLEGE DR#66146, ORANGE PARK, FL, 32065 |
| BUTLER SHIELA B | Agent | 225 COLLEGE DR#66146, ORANGE PARK, FL, 32065 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | - | - |
| REGISTERED AGENT NAME CHANGED | 2022-01-28 | BUTLER, SHIELA B | - |
| REINSTATEMENT | 2022-01-28 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2016-03-09 | 225 COLLEGE DR#66146, ORANGE PARK, FL 32065 | - |
| CHANGE OF MAILING ADDRESS | 2016-03-09 | 225 COLLEGE DR#66146, ORANGE PARK, FL 32065 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2016-03-09 | 225 COLLEGE DR#66146, ORANGE PARK, FL 32065 | - |
| Name | Date |
|---|---|
| REINSTATEMENT | 2022-01-28 |
| ANNUAL REPORT | 2020-06-05 |
| ANNUAL REPORT | 2019-04-22 |
| ANNUAL REPORT | 2018-04-16 |
| ANNUAL REPORT | 2017-04-23 |
| AMENDED ANNUAL REPORT | 2016-04-29 |
| ANNUAL REPORT | 2016-03-09 |
| ANNUAL REPORT | 2015-03-11 |
| ANNUAL REPORT | 2014-03-14 |
| ANNUAL REPORT | 2013-03-20 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2529487400 | 2020-05-06 | 0491 | PPP | 1700 Lismore Ct., MIDDLEBURG, FL, 32068-6703 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Apr 2025
Sources: Florida Department of State
