AGNES STREET HOME FOR THE ELDERLY
Nursing at Agnes St, Jacksonville, FL

License number
Florida AL5745
Category
Nursing
Type
Assisted Living Facility
Owner
Name: MR. ATAKELTE ADMASU
Title: OWNER/ADMINISTRATOR
Phone: (904) 766-7651
Address
Address
1346 Agnes St, Jacksonville, FL 32208
National Provider ID: 1275970204
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about AGNES STREET HOME FOR THE ELDERLY at bizstanding.com

AGNES STREET HOME FOR THE ELDERLY INC

Jacksonville, FL

Status:
Inactive
Inactive reason:
PENDING REINSTATEMENT
Registration:
Apr 14, 2006
Inactive since:
Aug 26, 2010
Addresses:
1346 Agnes St, Jacksonville, FL 32208 (Physical)
Jacksonville, FL 32236 (Mailing)
PO Box 60422, Jacksonville, FL 32236
State ID:
P06000053243
Business type:
Florida Profit Corporation
Secretarys:
Atakelte Admasu President, inactive, 7853 Summer Star Ct, Jacksonville, FL 32221 (Physical),Albert Admasu President, Vice President, inactive, 7853 Summer Star Ct, Jacksonville, FL 32221 (Physical),Abeba Admasu Secretary, inactive, 604 Martin Dr Lk E, Jacksonville, FL 32220 (Physical)
Agent:
Admasu, Atakelte,PO Box 60422, Jacksonville, FL 32236 (Physical)
EIN:
NO-NE

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