Entity Name: | FLORIDA CARE ALF OF VERO BEACH INC |
Jurisdiction: | FLORIDA |
Filing Type: | Domestic Profit |
Status: | Active |
Date Filed: | 28 May 2021 (4 years ago) |
Document Number: | P21000051076 |
FEI/EIN Number | 87-0989033 |
Mail Address: | 5944 Coral Ridge Drive, CORAL SPRINGS, FL, 33076, US |
Address: | 1934 22ND AVE, VERO BEACH, FL, 32960, US |
ZIP code: | 32960 |
County: | Indian River |
Place of Formation: | FLORIDA |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1265000723 | 2021-06-11 | 2021-06-11 | 7432 WILES RD, CORAL SPRINGS, FL, 330672066, US | 1934 22ND AVE, VERO BEACH, FL, 329603084, US | |||||||||||||||||||
|
Phone | +1 954-461-7435 |
Authorized person
Name | MR. JOSEPH V MONDELLI JR. |
Role | PRESIDENT |
Phone | 9544617435 |
Taxonomy
Taxonomy Code | 310400000X - Assisted Living Facility |
Is Primary | Yes |
Other Provider Identifiers
Issuer | MEDICAID |
Number | 1053704965 |
State | FL |
Name | Role | Address |
---|---|---|
MONDELLI JOSEPH V | Agent | 5944 Coral Ridge Drive, CORAL SPRINGS, FL, 33076 |
Name | Role | Address |
---|---|---|
MONDELLI JOSEPH V | President | 5944 Coral Ridge Drive, CORAL SPRINGS, FL, 33076 |
Name | Role | Address |
---|---|---|
Taylor Warren | Chief Executive Officer | 1739 NW 80 Ave C, Margate, FL, 33063 |
Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
---|---|---|---|---|---|---|
G21000074070 | SPRING HILLS ASSISTED LIVING FACILITY | ACTIVE | 2021-06-02 | 2026-12-31 | No data | 7432 WILES RD, CORAL SPRINGS, FL, 33067 |
Event Type | Filed Date | Value | Description |
---|---|---|---|
CHANGE OF MAILING ADDRESS | 2022-04-19 | 1934 22ND AVE, VERO BEACH, FL 32960 | No data |
REGISTERED AGENT ADDRESS CHANGED | 2022-04-19 | 5944 Coral Ridge Drive, 506, CORAL SPRINGS, FL 33076 | No data |
Name | Date |
---|---|
AMENDED ANNUAL REPORT | 2024-05-07 |
ANNUAL REPORT | 2024-04-27 |
AMENDED ANNUAL REPORT | 2023-10-04 |
ANNUAL REPORT | 2023-04-29 |
AMENDED ANNUAL REPORT | 2022-05-05 |
ANNUAL REPORT | 2022-04-19 |
Domestic Profit | 2021-05-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State