| Entity Name: | BELLE VISTA RETIREMENT HOME, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 03 Apr 1992 (33 years ago) |
| Date of dissolution: | 25 Sep 2020 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 years ago) |
| Document Number: | V25966 |
| FEI/EIN Number | 59-3122756 |
| Address: | 130 MIDWAY ISLAND, CLEARWATER, FL 33767 |
| Mail Address: | 130 Midway Is, NA, Clearwater, FL 33767 |
| ZIP code: | 33767 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992958185 | 2008-10-31 | 2008-10-31 | 1453 BELLEAIR RD, CLEARWATER, FL, 337562356, US | 1453 BELLEAIR RD, CLEARWATER, FL, 337562356, US | |||||||||||||||||||||||||
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| Phone | +1 727-587-0880 |
| Fax | 7275882397 |
Authorized person
| Name | BEVERLY C. MACKIN |
| Role | ADMINISTRATOR |
| Phone | 7275870880 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL7261 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 674094403 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MACKIN, BEVERLY | Agent | 130 Midway Is, Clearwater, FL 33767 |
| Name | Role | Address |
|---|---|---|
| MACKIN, BEVERLY | Treasurer | 130 MIDWAY ISLAND, CLEARWATER, FL 33767 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-03-08 | 130 MIDWAY ISLAND, CLEARWATER, FL 33767 | No data |
| CHANGE OF MAILING ADDRESS | 2019-03-08 | 130 MIDWAY ISLAND, CLEARWATER, FL 33767 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-03-08 | 130 Midway Is, Clearwater, FL 33767 | No data |
| REGISTERED AGENT NAME CHANGED | 1992-07-01 | MACKIN, BEVERLY | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-03-08 |
| ANNUAL REPORT | 2018-01-19 |
| ANNUAL REPORT | 2017-03-31 |
| ANNUAL REPORT | 2016-03-28 |
| ANNUAL REPORT | 2015-06-08 |
| ANNUAL REPORT | 2014-01-10 |
| ANNUAL REPORT | 2013-02-11 |
| ANNUAL REPORT | 2012-01-06 |
| ANNUAL REPORT | 2011-01-06 |
| ANNUAL REPORT | 2010-01-06 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
