| Entity Name: | TAMBOLINA SERVICES COMMUNITY RESIDENT HOME, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 15 Oct 2019 (5 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 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902404668 | 2020-10-15 | 2020-10-15 | 6285 CRANBERRY LN W, JACKSONVILLE, FL, 322442559, US | 6285 CRANBERRY LN W, JACKSONVILLE, FL, 322442559, US | |||||||||||||||
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| Phone | +1 904-651-1310 |
| Fax | 9042400309 |
Authorized person
| Name | TAMBA MEDZA MOMORIE |
| Role | ASSOCIATE ADMINISTRATOR |
| Phone | 9046299922 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MOMORIE TAMBA M | Agent | 11976 IRON CREEK RD, JACKSONVILLE, FL, 32218 |
| Name | Role | Address |
|---|---|---|
| MOMORIE TAMBA M | President | 11976 IRON CREEK RD, JACKSONVILLE, FL, 32218 |
| Name | Role | Address |
|---|---|---|
| FUSTER MOMORIE LINDA K | Vice President | 11976 IRON CREEK ROAD, JACKSONVILLE, FL, 32218 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2022-02-24 | 6285 CRANBERRY LN, WEST, JACKSONVILLE, FL 32244 | No data |
| 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 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
