| Entity Name: | WOODLANDS CARE CENTER OF ALACHUA COUNTY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 15 Dec 1999 (25 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | P99000108275 |
| FEI/EIN Number | 593613649 |
| Address: | 480 Fentress Blvd., Daytona Beach, FL, 32114, US |
| Mail Address: | 480 Fentress Blvd., Daytona Beach, FL, 32114, US |
| ZIP code: | 32114 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972572709 | 2006-03-15 | 2012-06-12 | 7207 SW 24TH AVE, GAINESVILLE, FL, 32607, US | 7207 SW 24TH AVE, GAINESVILLE, FL, 32607, US | |||||||||||||||||||||||||||
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| Phone | +1 352-333-0600 |
| Fax | 3523312974 |
| Fax | 3523317752 |
Authorized person
| Name | CHET MALANOWSKI |
| Role | ADMINISTRATOR |
| Phone | 3523330600 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 130471021 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 025557200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Bengio Jacob | Agent | 12221 West Dixie Hwy, North Miami, FL, 33161 |
| Name | Role | Address |
|---|---|---|
| ESFORMES MORRIS | President | 6865 N. LINCOLN AVE., LINCOLNWOOD, IL, 60712 |
| Name | Role | Address |
|---|---|---|
| ESFORMES MORRIS | Director | 6865 N. LINCOLN AVE., LINCOLNWOOD, IL, 60712 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2017-03-21 | 480 Fentress Blvd., Suite H, Daytona Beach, FL 32114 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-03-21 | Bengio, Jacob | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-03-21 | 12221 West Dixie Hwy, North Miami, FL 33161 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-02-16 | 480 Fentress Blvd., Suite H, Daytona Beach, FL 32114 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-03-21 |
| ANNUAL REPORT | 2016-04-05 |
| ANNUAL REPORT | 2015-02-16 |
| ANNUAL REPORT | 2014-04-20 |
| ANNUAL REPORT | 2013-03-20 |
| ANNUAL REPORT | 2012-04-06 |
| ANNUAL REPORT | 2011-04-18 |
| ANNUAL REPORT | 2010-04-12 |
| ANNUAL REPORT | 2009-04-03 |
| ANNUAL REPORT | 2008-04-16 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
