| Entity Name: | WOODLANDS CARE CENTER OF CITRUS 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: | P99000108280 |
| FEI/EIN Number | 593613650 |
| Address: | 480 Fentress Boulevard, Daytona Beach, FL, 32114, US |
| Mail Address: | 480 Fentress Boulevard, 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 | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760451900 | 2006-03-17 | 2012-07-27 | 124 W NORVELL BRYANT HWY, HERNANDO, FL, 344425105, US | 124 W NORVELL BRYANT HWY, HERNANDO, FL, 344425105, US | |||||||||||||||||||||||||
|
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| Phone | +1 352-249-3100 |
| Fax | 3527460748 |
Authorized person
| Name | MS. DONNA MARSH |
| Role | CFO |
| Phone | 3862551054 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 130471018 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 022871100 |
| State | FL |
| Name | Role |
|---|---|
| INCORP SERVICES, INC. | Agent |
| 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 | 2017-03-03 | 480 Fentress Boulevard, Suite H, Daytona Beach, FL 32114 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-04-05 | 17888 67TH COURT NORTH, LOXAHATCHEE, FL 33470 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-02-16 | 480 Fentress Boulevard, Suite H, Daytona Beach, FL 32114 | No data |
| REGISTERED AGENT NAME CHANGED | 2008-04-16 | INCORP SERVICES | No data |
| Name | Date |
|---|---|
| Reg. Agent Resignation | 2022-10-20 |
| ANNUAL REPORT | 2017-03-03 |
| 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 | 2011-03-30 |
| ANNUAL REPORT | 2010-04-13 |
| ANNUAL REPORT | 2009-04-03 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
