| Entity Name: | THE FOUNTAINS NURSING HOME, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 16 Dec 1994 (30 years ago) |
| Date of dissolution: | 13 Apr 2017 (8 years ago) |
| Last Event: | VOLUNTARY DISS W/ NOTICE |
| Event Date Filed: | 13 Apr 2017 (8 years ago) |
| Document Number: | P94000091489 |
| FEI/EIN Number | 650619523 |
| Address: | 3800 NORTH FEDERAL HIGHWAY, BOCA RATON, FL, 33431, US |
| Mail Address: | 740 EAST AVENUE, ROCHESTER, NY, 14607, US |
| ZIP code: | 33431 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528063666 | 2005-06-16 | 2011-12-28 | 3800 N FEDERAL HWY, BOCA RATON, FL, 334314523, US | 3800 N FEDERAL HWY, BOCA RATON, FL, 334314523, US | |||||||||||||||||||||||||
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| Phone | +1 561-395-7510 |
| Fax | 5613951517 |
Authorized person
| Name | MR. DENNIS L MART |
| Role | CFO |
| Phone | 5852440410 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 1165096 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 021239300 |
| State | FL |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| HURLBUT ROBERT W | President | 295 AMBASSADOR DRIVE, ROCHESTER, NY, 14610 |
| Name | Role | Address |
|---|---|---|
| HURLBUT CHRISTINE A | Vice President | 796 BEACH AVENUE, ROCHESTER, NY, 14610 |
| Name | Role | Address |
|---|---|---|
| HURLBUT CHRISTINE A | Secretary | 796 BEACH AVENUE, ROCHESTER, NY, 14610 |
| Name | Role | Address |
|---|---|---|
| HURLBUT CHRISTINE A | Director | 796 BEACH AVENUE, ROCHESTER, NY, 14610 |
| Name | Role | Address |
|---|---|---|
| Reed Bridgett | Chief Financial Officer | 740 East Ave, Rochester, NY, 14607 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISS W/ NOTICE | 2017-04-13 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-01-21 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| REINSTATEMENT | 2014-01-21 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2014-01-21 | C T CORPORATION SYSTEM | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2009-01-07 | 3800 NORTH FEDERAL HIGHWAY, BOCA RATON, FL 33431 | No data |
| REINSTATEMENT | 2006-04-07 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2005-09-16 | No data | No data |
| Name | Date |
|---|---|
| CORAPVDWN | 2017-04-13 |
| ANNUAL REPORT | 2017-04-03 |
| ANNUAL REPORT | 2016-01-04 |
| ANNUAL REPORT | 2015-01-19 |
| Reinstatement | 2014-01-21 |
| ANNUAL REPORT | 2012-01-06 |
| ANNUAL REPORT | 2011-01-06 |
| ANNUAL REPORT | 2010-01-11 |
| ANNUAL REPORT | 2009-01-07 |
| ANNUAL REPORT | 2008-01-24 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
