| Entity Name: | BEAR LAKE RETIREMENT HOME, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 31 Jan 1997 (28 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 30 Apr 2008 (17 years ago) |
| Document Number: | P97000011199 |
| FEI/EIN Number | 593432975 |
| Address: | 1525 BEAR LAKE RD, APOPKA, FL, 32703, US |
| Mail Address: | 1407 BEAR LAKE ROAD, APOPKA, FL, 32703 |
| ZIP code: | 32703 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962849778 | 2013-06-03 | 2013-06-03 | 1525 BEAR LAKE RD, APOPKA, FL, 327036736, US | 1525 BEAR LAKE RD, APOPKA, FL, 327036736, US | |||||||||||||||||||||||||
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| Phone | +1 407-296-7075 |
| Fax | 3214454740 |
Authorized person
| Name | MARINA NIEVES |
| Role | OWNER |
| Phone | 4072967075 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL8413 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 140986700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| NIEVES MARINA | Agent | 1407 BEAR LAKE ROAD, APOPKA, FL, 32703 |
| Name | Role | Address |
|---|---|---|
| NIEVES MARINA | Director | 1407 BEAR LAKE ROAD, APOPKA, FL, 32703 |
| NIEVES GUADALUPE | Director | 1407 BEAR LAKE ROAD, APOPKA, FL, 32703 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2015-04-30 | 1525 BEAR LAKE RD, APOPKA, FL 32703 | No data |
| CANCEL ADM DISS/REV | 2008-04-30 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| REINSTATEMENT | 2003-10-03 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2003-09-19 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-05-01 |
| ANNUAL REPORT | 2022-04-30 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-06-29 |
| ANNUAL REPORT | 2019-05-01 |
| ANNUAL REPORT | 2018-04-10 |
| ANNUAL REPORT | 2017-04-10 |
| ANNUAL REPORT | 2016-04-25 |
| ANNUAL REPORT | 2015-04-30 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
