| Entity Name: | ENHANCED LIVING CONSULTANTS INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 03 Jun 2021 (4 years ago) |
| Document Number: | P21000052290 |
| FEI/EIN Number | 87-1080349 |
| Address: | 4040 EDGEWOOD DRIVE, COCONUT CREEK, FL, 33066 |
| Mail Address: | 4040 EDGEWOOD DRIVE, COCONUT CREEK, FL, 33066 |
| ZIP code: | 33066 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205692696 | 2024-02-23 | 2024-02-23 | 4040 EDGEWOOD DR, COCONUT CREEK, FL, 330661835, US | 4040 EDGEWOOD DR, COCONUT CREEK, FL, 330661835, US | |||||||||||||||||||||||||
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| Phone | +1 954-980-5002 |
Authorized person
| Name | MICHAEL GIPSON |
| Role | PRESIDENT |
| Phone | 9549805002 |
Taxonomy
| Taxonomy Code | 171WH0202X - Home Modifications Contractor |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 113563300 |
| State | FL |
| Issuer | MEDICAID |
| Number | 114401600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GIPSON MICHAEL G | Agent | 4040 EDGEWOOD DRIVE, COCONUT CREEK, FL, 33066 |
| Name | Role | Address |
|---|---|---|
| GIPSON MICHAEL G | President | 4040 EDGEWOOD DRIVE, COCONUT CREEK, FL, 33066 |
| Name | Role | Address |
|---|---|---|
| FURMAN ELLA | Vice President | 800 PARKVIEW DRIVE #307, HALLANDALE BEACH, FL, 33009 |
| Name | Role | Address |
|---|---|---|
| GIPSON MICHAEL G | Secretary | 4040 EDGEWOOD DRIVE, COCONUT CREEK, FL, 33066 |
| Name | Role | Address |
|---|---|---|
| FURMAN ELLA | Treasurer | 800 PARKVIEW DRIVE #307, HALLANDALE BEACH, FL, 33009 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-18 |
| ANNUAL REPORT | 2023-03-13 |
| ANNUAL REPORT | 2022-03-10 |
| Domestic Profit | 2021-06-03 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
