| Entity Name: | SANDY LEMKE SUPPORTED LIVING SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 11 Jun 1993 (32 years ago) |
| Date of dissolution: | 19 Jan 2023 (2 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 19 Jan 2023 (2 years ago) |
| Document Number: | P93000041779 |
| FEI/EIN Number | 593188825 |
| Address: | 318 Country Club Drive, Oldsmar, FL, 34677, US |
| Mail Address: | 2492 CR 673, Bushnell, FL, 33513, US |
| ZIP code: | 34677 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568764371 | 2010-11-30 | 2010-11-30 | PO BOX 16521, ST PETERSBURG, FL, 337336521, US | 735 38TH AVE S, ST PETERSBURG, FL, 337053837, US | |||||||||||||||||||||||||||||
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| Phone | +1 727-823-9160 |
| Fax | 7278248841 |
Authorized person
| Name | MS. SANDRA ANN LEMKE |
| Role | PRESIDENT |
| Phone | 7278239160 |
Taxonomy
| Taxonomy Code | 251C00000X - Developmentally Disabled Services Day Training Agency |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID DEVELOPMENTAL DISABILITIES HOME AND COMMUNITY BASED WAIVER NUMBER |
| Number | 672827896 |
| State | FL |
| Issuer | MEDICAID DEVELOPMENTAL DISABILITIES FAMILY AND SUPPORTED LIVING WAIVER |
| Number | 672827801 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LEMKE SANDRA A. | Agent | 2492 CR 673, Bushnell, FL, 33513 |
| Name | Role | Address |
|---|---|---|
| LEMKE SANDRA A | President | 2492 CR 673, Bushnell, FL, 33513 |
| Name | Role | Address |
|---|---|---|
| LEMKE SANDRA A | Vice President | 2492 CR 673, Bushnell, FL, 33513 |
| Name | Role | Address |
|---|---|---|
| LEMKE SANDRA A | Treasurer | 2492 CR 673, Bushnell, FL, 33513 |
| Name | Role | Address |
|---|---|---|
| LEMKE SANDRA A | Secretary | 2492 CR 673, Bushnell, FL, 33513 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2023-01-19 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-04-05 | 2492 CR 673, Bushnell, FL 33513 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-06-15 | 318 Country Club Drive, Oldsmar, FL 34677 | No data |
| CHANGE OF MAILING ADDRESS | 2020-06-15 | 318 Country Club Drive, Oldsmar, FL 34677 | No data |
| REINSTATEMENT | 1995-09-25 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1995-08-25 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 1994-08-02 | LEMKE, SANDRA A. | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2023-01-19 |
| ANNUAL REPORT | 2022-04-04 |
| ANNUAL REPORT | 2021-04-05 |
| ANNUAL REPORT | 2020-06-15 |
| ANNUAL REPORT | 2019-04-11 |
| ANNUAL REPORT | 2018-04-06 |
| ANNUAL REPORT | 2017-04-07 |
| ANNUAL REPORT | 2016-04-04 |
| ANNUAL REPORT | 2015-03-23 |
| ANNUAL REPORT | 2014-04-01 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
