| Entity Name: | ILEANA'S CARE HOME, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 26 Oct 2017 (7 years ago) |
| Document Number: | P17000086517 |
| FEI/EIN Number | 82-3210523 |
| Address: | 6401 WEST CLIFTON STREET, TAMPA, FL 33634 |
| Mail Address: | 6401 WEST CLIFTON STREET, TAMPA, FL 33634 |
| ZIP code: | 33634 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902559289 | 2022-01-27 | 2022-01-27 | 6401 W CLIFTON ST, TAMPA, FL, 336345010, US | 6401 W CLIFTON ST, TAMPA, FL, 336345010, US | |||||||||||||||||||||
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| Phone | +1 201-741-5460 |
| Fax | 8135597301 |
Authorized person
| Name | ILEANA BERMUDEZ |
| Role | ADMINISTRATOR |
| Phone | 2017415460 |
Taxonomy
| Taxonomy Code | 261QD1600X - Developmental Disabilities Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 022857600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BERMUDEZ, ILEANA | Agent | 6401 WEST CLIFTON STREET, TAMPA, FL 33634 |
| Name | Role | Address |
|---|---|---|
| BERMUDEZ, ILEANA | President | 6401 WEST CLIFTON STREET, TAMPA, FL 33634 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-15 |
| ANNUAL REPORT | 2024-03-04 |
| ANNUAL REPORT | 2023-04-11 |
| ANNUAL REPORT | 2022-04-28 |
| AMENDED ANNUAL REPORT | 2021-07-09 |
| ANNUAL REPORT | 2021-04-09 |
| ANNUAL REPORT | 2020-04-13 |
| ANNUAL REPORT | 2019-04-04 |
| ANNUAL REPORT | 2018-04-15 |
| Domestic Profit | 2017-10-26 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 3344858703 | 2021-03-31 | 0455 | PPP | 6401 W Clifton St 7304 Woodhall Ct, Tampa, FL, 33634-5010 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 17 Feb 2025
Sources: Florida Department of State
