| Entity Name: | WELLSPRINGS HEALTH CARE PARTNERS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 23 Oct 2019 (5 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 06 May 2024 (9 months ago) |
| Document Number: | P19000082930 |
| FEI/EIN Number | 84-3455990 |
| Address: | 1645 Palm Beach Lakes Blvd, West Palm Beach, FL, 33401, US |
| Mail Address: | PO BOX 3614, OCALA, FL, 34478, US |
| ZIP code: | 33401 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598309718 | 2019-10-30 | 2021-03-22 | PO BOX 3614, OCALA, FL, 344783614, US | 19204 NW US HIGHWAY 441, HIGH SPRINGS, FL, 326438783, US | |||||||||||||||||||||
|
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| Phone | +1 386-454-7746 |
| Fax | 3864543034 |
Authorized person
| Name | ANDREA C JOHNSON |
| Role | PRESIDENT |
| Phone | 3864547746 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 107400100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| JOHNSON ANDREA C | Agent | 1645 Palm Beach Lakes Blvd, West Palm Beach, FL, 33401 |
| Name | Role | Address |
|---|---|---|
| JOHNSON ANDREA C | President | PO BOX 3614, OCALA, FL, 34478 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000121296 | WELLSPRINGS HEALTH CARE CENTER | ACTIVE | 2020-09-17 | 2025-12-31 | No data | PO BOX 3614, OCALA, FL, 34478 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-05-06 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-05-06 | 1645 Palm Beach Lakes Blvd, Suite 1200, West Palm Beach, FL 33401 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-05-06 | JOHNSON, ANDREA C | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-05-06 | 1645 Palm Beach Lakes Blvd, Suite 1200, West Palm Beach, FL 33401 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-05-06 |
| ANNUAL REPORT | 2022-03-01 |
| ANNUAL REPORT | 2021-03-07 |
| Domestic Profit | 2019-10-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
