| Entity Name: | THE HOUSE OF MERCY CORP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 09 Aug 2017 (7 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 13 Aug 2021 (3 years ago) |
| Document Number: | P17000066949 |
| FEI/EIN Number | 82-5206796 |
| Address: | 2804 DEL PRADO BLVD S, 104, CAPE CORAL, FL 33904 |
| Mail Address: | 1418 SE 28TH TERRACE, CAPE CORAL, FL 33904 |
| ZIP code: | 33904 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821551243 | 2019-04-11 | 2021-12-10 | 1418 SE 28TH TER, CAPE CORAL, FL, 339043917, US | 1418 SE 28TH TER, CAPE CORAL, FL, 339043917, US | |||||||||||||||||||||||||
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| Phone | +1 239-257-9636 |
| Fax | 7867176435 |
Authorized person
| Name | MRS. ZUNILDA PUENTES |
| Role | PRESIDENT |
| Phone | 2392579636 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | No |
| Taxonomy Code | 261QD1600X - Developmental Disabilities Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 100159200 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THE HOUSE OF MERCY CORP 401K PLAN | 2023 | 825206796 | 2024-09-05 | THE HOUSE OF MERCY CORP | 2 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-09-05 |
| Name of individual signing | NICK RICE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-04-01 |
| Business code | 621610 |
| Sponsor’s telephone number | 2392197136 |
| Plan sponsor’s address | 1418 SE 28TH TER, CAPE CORAL, FL, 33904 |
Signature of
| Role | Plan administrator |
| Date | 2023-09-14 |
| Name of individual signing | SHIRLEY HORNER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Guevara, Juan | Agent | 1418 SE 28TH TERRACE, CAPE CORAL, FL 33904 |
| Name | Role | Address |
|---|---|---|
| PUENTES, ZUNILDA | President | 1418 SE 28TH TERRACE, CAPE CORAL, FL 33904 |
| Name | Role | Address |
|---|---|---|
| PUENTES, ZUNILDA | Chief Executive Officer | 1418 SE 28TH TERRACE, CAPE CORAL, FL 33904 |
| Name | Role | Address |
|---|---|---|
| GUEVARA, JUAN MIGUEL, JR | Vice President | 1418 SE 28TH TERRACE, CAPE CORAL, FL 33904 |
| Name | Role | Address |
|---|---|---|
| GUEVARA, JUAN MIGUEL, JR | Chief Financial Officer | 1418 SE 28TH TERRACE, CAPE CORAL, FL 33904 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-11-17 | 2804 DEL PRADO BLVD S, 104, CAPE CORAL, FL 33904 | No data |
| AMENDMENT | 2021-08-13 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2018-09-04 | Guevara, Juan | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-11 |
| ANNUAL REPORT | 2023-01-19 |
| AMENDED ANNUAL REPORT | 2022-11-17 |
| ANNUAL REPORT | 2022-02-01 |
| Amendment | 2021-08-13 |
| ANNUAL REPORT | 2021-02-24 |
| ANNUAL REPORT | 2020-05-09 |
| ANNUAL REPORT | 2019-01-08 |
| ANNUAL REPORT | 2018-09-04 |
| Domestic Profit | 2017-08-09 |
Date of last update: 18 Jan 2025
Sources: Florida Department of State
