| Entity Name: | EVERGREEN MANOR RETIREMENT HOME, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
EVERGREEN MANOR RETIREMENT HOME, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 22 Sep 1995 (30 years ago) |
| Date of dissolution: | 26 Sep 2014 (11 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (11 years ago) |
| Document Number: | P95000073910 |
| FEI/EIN Number |
650627559
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 3297 STATE ROAD 580, SAFTY HARBOR, FL, 34695, US |
| Mail Address: | 3297 STATE ROAD 580, SAFTY HARBOR, FL, 34695, US |
| ZIP code: | 34695 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366697153 | 2008-11-21 | 2008-11-21 | 3297 STATE ROAD 580, SAFETY HARBOR, FL, 346954929, US | 3297 STATE ROAD 580, SAFETY HARBOR, FL, 346954929, US | |||||||||||||||||
|
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| Phone | +1 727-724-3776 |
Authorized person
| Name | YEE-CHUN TAN KAPUSINSKY |
| Role | ADMINISTRATOR |
| Phone | 7274802180 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL8760 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KAPUSINSKY YEE-CHUN | Owne | 3348 LAKE SHORE LANE, CLEARWATER, FL, 33761 |
| BROSS JENNIFER | Admi | 414 PINEWOOD DRIVE, OLDSMAR, FL, 34677 |
| SIMPSON TESHA | Co | 736 BRITTANY PARK BLVD, TARPON SPRINGS, FL, 34689 |
| SIMPSON TESHA | a | 736 BRITTANY PARK BLVD, TARPON SPRINGS, FL, 34689 |
| Simpson Tesha | Agent | 3297 State Road 580, Safety Harbor, FL, 34695 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | - | - |
| REGISTERED AGENT NAME CHANGED | 2013-06-12 | Simpson, Tesha | - |
| REGISTERED AGENT ADDRESS CHANGED | 2013-06-12 | 3297 State Road 580, Safety Harbor, FL 34695 | - |
| CHANGE OF MAILING ADDRESS | 2010-03-06 | 3297 STATE ROAD 580, SAFTY HARBOR, FL 34695 | - |
| CHANGE OF PRINCIPAL ADDRESS | 1998-01-21 | 3297 STATE ROAD 580, SAFTY HARBOR, FL 34695 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-06-12 |
| ANNUAL REPORT | 2012-04-30 |
| ANNUAL REPORT | 2012-04-25 |
| ANNUAL REPORT | 2011-05-01 |
| ANNUAL REPORT | 2010-03-06 |
| ANNUAL REPORT | 2009-03-15 |
| ANNUAL REPORT | 2008-05-11 |
| ANNUAL REPORT | 2007-04-23 |
| ANNUAL REPORT | 2006-03-02 |
| ANNUAL REPORT | 2005-02-11 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
