| Entity Name: | GENESIS ALF OF TAMPA MANAGEMENT GROUP CORP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 28 Aug 2017 (7 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | P17000072086 |
| FEI/EIN Number | APPLIED FOR |
| Address: | 1108 Black knight dr, Valrico, FL, 33594, US |
| Mail Address: | 1108 Black knight dr, Valrico, FL, 33594, US |
| ZIP code: | 33594 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417438854 | 2018-08-23 | 2018-08-23 | 1108 BLACK KNIGHT DR, VALRICO, FL, 335945800, US | 1108 BLACK KNIGHT DR, VALRICO, FL, 335945800, US | |||||||||||||||||||||||
|
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| Phone | +1 813-530-0909 |
Authorized person
| Name | GLADYS KANODEREKA |
| Role | ADMINISTRATOR |
| Phone | 8133308424 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL12747 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | LICENSE NUMBER |
| Number | AL12747 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KANODEREKA GLADYS | Agent | 12804 AVELAR CREEK DR, RIVERVIEW, FL, 33578 |
| Name | Role | Address |
|---|---|---|
| Kanodereka Gladys | President | 12804 avelar creeek dr, Riverview, FL, 33578 |
| Name | Role | Address |
|---|---|---|
| Mpondo Samuel | Secretary | 12804 avelar creeek dr, Riverview, FL, 33578 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000134437 | OPTIMUM HOME CARE | EXPIRED | 2019-12-19 | 2024-12-31 | No data | 1108 BLACK KNIGHT DR, VALRICO, FL, 33578 |
| G18000100894 | GENESIS ALF VALRICO | EXPIRED | 2018-09-12 | 2023-12-31 | No data | 1108 BLACKKNIGHT DR, VALRICO, FL, 33578 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-08-24 | 1108 Black knight dr, Valrico, FL 33594 | No data |
| CHANGE OF MAILING ADDRESS | 2018-08-24 | 1108 Black knight dr, Valrico, FL 33594 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-08-24 | 12804 AVELAR CREEK DR, RIVERVIEW, FL 33578 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J22000314981 | TERMINATED | 1000000926850 | HILLSBOROU | 2022-06-22 | 2032-06-29 | $ 1,447.15 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, TAMPA SERVICE CENTER, 5483 W WATERS AVE STE 1210, TAMPA FL336341236 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-04-27 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-08-24 |
| Domestic Profit | 2017-08-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
