| Entity Name: | OAK VILLAGE ALF, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 13 Aug 2019 (6 years ago) |
| Document Number: | P19000063808 |
| FEI/EIN Number | 84-2736995 |
| Mail Address: | 3022 Castelli Blvd, Mount Dora, FL, 32757, US |
| Address: | 1801 MONASTERY RD., ORANGE CITY, FL, 32763, US |
| ZIP code: | 32763 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1942836101 | 2020-03-19 | 2020-03-19 | 33857 TERRAGONA DR, SORRENTO, FL, 327766918, US | 1801 MONASTERY RD, ORANGE CITY, FL, 327636320, US | |||||||||||||||||||
|
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| Phone | +1 503-833-2814 |
Authorized person
| Name | SAM BONGIOVANNI |
| Role | PRESIDENT |
| Phone | 5038332814 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | NONE |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BONGIOVANNI SAMUEL F | Agent | 3022 Castelli Blvd, Mount Dora, FL, 32757 |
| Name | Role | Address |
|---|---|---|
| BONGIOVANNI SAMUEL F | President | 3022 Castelli Blvd, Mount Dora, FL, 32757 |
| Name | Role | Address |
|---|---|---|
| BHAGWANSINGH MARTHA | Vice President | 34115 Fortunado St, SORRENTO, FL, 32776 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000086446 | OAK VILLAGE | EXPIRED | 2019-08-15 | 2024-12-31 | No data | 1801 MONASTERY ROAD, ORANGE CITY, FL, 32763 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-02-26 | BONGIOVANNI, SAMUEL F | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-10 | 1801 MONASTERY RD., ORANGE CITY, FL 32763 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-10 | 3022 Castelli Blvd, Mount Dora, FL 32757 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-26 |
| ANNUAL REPORT | 2023-04-10 |
| ANNUAL REPORT | 2022-05-01 |
| ANNUAL REPORT | 2021-04-09 |
| ANNUAL REPORT | 2020-03-20 |
| Domestic Profit | 2019-08-13 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
