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TAMBOLINA SERVICES COMMUNITY RESIDENT HOME, INC. - Florida Company Profile

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Company Details

Entity Name: TAMBOLINA SERVICES COMMUNITY RESIDENT HOME, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 15 Oct 2019 (6 years ago)
Document Number: P19000078409
FEI/EIN Number 83-4329191
Mail Address: 1627 ROGERO ROAD, JACKSONVILLE, FL, 32211, US
Address: 6285 CRANBERRY LN, WEST, JACKSONVILLE, FL, 32244, US
ZIP code: 32244
City: Jacksonville
County: Duval
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
MOMORIE TAMBA M President 11976 IRON CREEK RD, JACKSONVILLE, FL, 32218
FUSTER MOMORIE LINDA K Vice President 11976 IRON CREEK ROAD, JACKSONVILLE, FL, 32218
MOMORIE TAMBA M Agent 11976 IRON CREEK RD, JACKSONVILLE, FL, 32218

National Provider Identifier

NPI Number:
1902404668
Certification Date:
2020-10-14

Authorized Person:

Name:
TAMBA MEDZA MOMORIE
Role:
ASSOCIATE ADMINISTRATOR
Phone:

Taxonomy:

Selected Taxonomy:
310400000X - Assisted Living Facility
Is Primary:
Yes

Contacts:

Fax:
9042400309

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2022-02-24 6285 CRANBERRY LN, WEST, JACKSONVILLE, FL 32244 -

Documents

Name Date
ANNUAL REPORT 2024-03-05
ANNUAL REPORT 2023-03-15
ANNUAL REPORT 2022-02-24
ANNUAL REPORT 2021-03-15
ANNUAL REPORT 2020-03-31
Domestic Profit 2019-10-15

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Date of last update: 03 Jul 2025

Sources: Florida Department of State