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NEW JACKSON MANOR, LLC

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Company Details

Name: NEW JACKSON MANOR, LLC
Legal type: Foreign Limited Liability Company
Status: Inactive
Standing: Bad
File Date: 24 Jun 2005 (20 years ago)
Authority Date: 24 Jun 2005 (20 years ago)
Last Annual Report: 12 Jun 2018 (7 years ago)
Organization Number: 0616145
ZIP code: 40222
City: Louisville, Bancroft, Bellemeade, Crossgate, Glenvie...
Primary County: Jefferson County
Principal Office: 700 N. HURSTBOURNE PARKWAY, SUITE 200, LOUISVILLE, KY 40222
Place of Formation: DELAWARE

Manager

Name Role
J. Timothy Wesley Manager
Robin L. Barber Manager
W. Patrick Mulloy Manager

Organizer

Name Role
EPI HEALTHCARE, LLC Organizer

Registered Agent

Name Role
KY SECRETARY OF STATE Registered Agent

National Provider Identifier

NPI Number:
1407845639

Authorized Person:

Name:
ROBIN L. BARBER
Role:
VICE PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
261QA0600X - Adult Day Care Clinic/Center
Is Primary:
No
Selected Taxonomy:
314000000X - Skilled Nursing Facility
Is Primary:
No
Selected Taxonomy:
261QA0600X - Adult Day Care Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
5027536104
Fax:
6063642293

Assumed Names

Name Status Expiration Date
JACKSON MANOR HEALTH & REHABILITATION CENTER Inactive 2018-01-23
JACKSON MANOR Inactive 2015-07-11

Filings

Name File Date
Revocation of Certificate of Authority 2019-10-16
Annual Report 2018-06-12
Renewal of Assumed Name Return 2017-07-27
Annual Report 2017-05-25
Principal Office Address Change 2016-03-25

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Sources: Kentucky Secretary of State