| Entity Name: | QUALITY OF LIFE HOME HEALTH SERVICES OF HILLSBOROUGH, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 24 Oct 1996 (28 years ago) |
| Document Number: | P96000087858 |
| FEI/EIN Number | 593405672 |
| Address: | 7235 BRYAN DAIRY ROAD, LARGO, FL, 33777 |
| Mail Address: | 7235 BRYAN DAIRY ROAD, LARGO, FL, 33777 |
| ZIP code: | 33777 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427175306 | 2007-03-23 | 2008-07-02 | 7235 BRYAN DAIRY RD, LARGO, FL, 33777, US | 2919 SWANN AVE, SUITE 400C, TAMPA, FL, 33609, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 727-546-9692 |
| Fax | 7275470942 |
| Phone | +1 813-872-8103 |
Authorized person
| Name | MR. JAMES E. HEENAN |
| Role | CHIEF FINANCIAL OFFICER |
| Phone | 7275469692 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | 299991075 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | CLIA PROVIDER NUMBER |
| Number | E9183 |
| State | FL |
| Issuer | MEDICAID |
| Number | 650915100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HEENAN JAMES E | Agent | 7235 BRYAN DAIRY ROAD, LARGO, FL, 33777 |
| Name | Role | Address |
|---|---|---|
| MOSES MICHAEL J | President | 7235 BRYAN DAIRY ROAD, LARGO, FL, 33777 |
| Name | Role | Address |
|---|---|---|
| MOSES MICHAEL J | Director | 7235 BRYAN DAIRY ROAD, LARGO, FL, 33777 |
| HEENAN JAMES E | Director | 7235 BRYAN DAIRY ROAD, LARGO, FL, 33777 |
| BOSWORTH LOIS | Director | 7235 BRYAN DAIRY ROAD, LARGO, FL, 33777 |
| Name | Role | Address |
|---|---|---|
| HEENAN JAMES E | Treasurer | 7235 BRYAN DAIRY ROAD, LARGO, FL, 33777 |
| Name | Role | Address |
|---|---|---|
| BOSWORTH LOIS | Secretary | 7235 BRYAN DAIRY ROAD, LARGO, FL, 33777 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| REINSTATEMENT | 1999-10-06 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1999-09-24 | No data | No data |
Date of last update: 03 Jan 2025
Sources: Florida Department of State
