| Entity Name: | SPRUCE CREEK ASSISTED LIVING FACILITY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 20 Mar 2013 (12 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | P13000025926 |
| FEI/EIN Number | 46-2584975 |
| Address: | 5953 BROKEN BOW LANE, PORT ORANGE, FL, 32127 |
| Mail Address: | 260 SPRING FOREST DR., NEW SMYRNA BEACH, FL, 32168 |
| ZIP code: | 32127 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760894810 | 2014-05-23 | 2014-05-23 | 260 SPRING FOREST DR, NEW SMYRNA BEACH, FL, 321688700, US | 260 SPRING FOREST DR, NEW SMYRNA BEACH, FL, 321688700, US | |||||||||||||||||
|
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| Phone | +1 386-527-3781 |
Authorized person
| Name | DR. TAMELA SUE OWENS |
| Role | ADMINISTRATOR |
| Phone | 3865273781 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | 12422 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| OWENS TAMELA S | Agent | 260 SPRING FOREST DR., NEW SMYRNA BEACH, FL, 32168 |
| Name | Role | Address |
|---|---|---|
| OWENS TAMELA S | President | 260 SPRING FOREST DR., NEW SMYRNA BEACH, FL, 32168 |
| Name | Role | Address |
|---|---|---|
| WELBORN GARY S | Vice President | 260 SPRING FOREST DR., NEW SMYRNA BEACH, FL, 32168 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-04-17 |
| ANNUAL REPORT | 2016-03-04 |
| ANNUAL REPORT | 2015-02-23 |
| ANNUAL REPORT | 2014-03-02 |
| Domestic Profit | 2013-03-20 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
