| Entity Name: | PRESTIGE SENIOR CARE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 12 Apr 2021 (4 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | P21000035011 |
| Address: | 10151 DEERWOOD PARK BLVD, JACKSONVILLE, FL, 32216 |
| Mail Address: | 8450 GATE PKWY W, UNIT 1330, JACKSONVILLE, FL, 32216 |
| ZIP code: | 32216 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1275113565 | 2021-04-11 | 2021-04-11 | 8450 GATE PKWY W UNIT 1330, JACKSONVILLE, FL, 322161072, US | 10151 DEERWOOD PARK BLVD STE 250, JACKSONVILLE, FL, 322560566, US | |||||||||||||||||||||
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| Phone | +1 904-545-5481 |
| Phone | +1 800-438-6702 |
Authorized person
| Name | DR. KIMBERLY MIX |
| Role | OWNER |
| Phone | 9045455481 |
Taxonomy
| Taxonomy Code | 103TC2200X - Clinical Child & Adolescent Psychologist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | HOME HEALTH AIDE |
| Number | 1154907897 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MIX KIMBERLY | Agent | 8450 GATE PKWY W, JACKSONVILLE, FL, 32216 |
| Name | Role | Address |
|---|---|---|
| MIX KIMBERLY | President | 8450 GATE PKWY W. UNIT 1330, JACKSONVILLE, FL, 32216 |
| Name | Role | Address |
|---|---|---|
| PRATT KIMORA J | Vice President | 8450 GATE PKWY W. UNIT 1330, JACKSONVILLE, FL, 32216 |
| Name | Role | Address |
|---|---|---|
| WALLS WYATT J | Director | 8450 GATE PKWY W. UNIT 1330, JACKSONVILLE, FL, 32216 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| Name | Date |
|---|---|
| Domestic Profit | 2021-04-12 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
