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SUMMERVILLE AT PORT ORANGE, INC. - Florida Company Profile

Company Details

Entity Name: SUMMERVILLE AT PORT ORANGE, INC.
Jurisdiction: FLORIDA
Filing Type: Foreign Profit
Status: Inactive

The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders.

Date Filed: 04 May 1998 (27 years ago)
Date of dissolution: 05 Nov 2020 (4 years ago)
Last Event: WITHDRAWAL
Event Date Filed: 05 Nov 2020 (4 years ago)
Document Number: F98000002517
FEI/EIN Number 522103425

Federal Employer Identification (FEI) Number assigned by the IRS.

Mail Address: 111 WESTWOOD PLACE, SUITE 400, BRENTWOOD, TN, 37027
Address: 111 Westwood Place, Brentwood, TN, 37027, US
Place of Formation: DELAWARE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1750545158 2008-07-15 2016-05-13 6737 W WASHINGTON ST, SUITE 2300, MILWAUKEE, WI, 532145647, US 1675 DUNLAWTON AVE, PORT ORANGE, FL, 321274755, US

Contacts

Phone +1 386-761-1055
Fax 3867614408

Authorized person

Name BRYAN RICHARDSON
Role EVP, CHIEF ADMIN. OFFICER
Phone 6155648131

Taxonomy

Taxonomy Code 310400000X - Assisted Living Facility
License Number AL9792
State FL
Is Primary Yes
Taxonomy Code 311500000X - Alzheimer Center (Dementia Center)
Is Primary No

Other Provider Identifiers

Issuer MEDICAID
Number 0111336-00
State FL

Key Officers & Management

Name Role Address
Patchett Mary Sue Executive Vice President 111 Westwood Place, Brentwood, TN, 37027
Baier Lucinda M Chief Executive Officer 111 Westwood Place, Brentwood, TN, 37027
White Chad C Executive Vice President 111 Westwood Place, Brentwood, TN, 37027
Leskowicz Joanne Secretary 6737 W. Washington, Milwaukee, WI, 53214
Leskowicz Joanne Vice President 6737 W. Washington, Milwaukee, WI, 53214
Swain Steven Chief Financial Officer 111 Westwood Place, Brentwood, TN, 37027

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G15000012844 BROOKDALE YORKTOWNE EXPIRED 2015-02-04 2020-12-31 - 111 WESTWOOD PL STE 400, BRENTWOOD, TN, 37027
G08149900378 EMERITUS AT PORT ORANGE EXPIRED 2008-05-28 2013-12-31 - 3131 ELLIOTT AVENUE, SUITE 500, SEATTLE, WA, 98121

Events

Event Type Filed Date Value Description
REGISTERED AGENT CHANGED 2020-11-05 REGISTERED AGENT REVOKED -
WITHDRAWAL 2020-11-05 - -
CHANGE OF MAILING ADDRESS 2020-11-05 111 Westwood Place, Suite 400, Brentwood, TN 37027 -
CHANGE OF PRINCIPAL ADDRESS 2017-04-27 111 Westwood Place, Suite 400, Brentwood, TN 37027 -
REINSTATEMENT 2004-12-22 - -
REVOKED FOR ANNUAL REPORT 2004-10-01 - -
REINSTATEMENT 2000-11-03 - -
REVOKED FOR ANNUAL REPORT 2000-09-22 - -

Debts

Document Number Status Case Number Name of Court Date of Entry Expiration Date Amount Due Plaintiff
J13001804773 TERMINATED 1000000557059 LEON 2013-12-05 2033-12-26 $ 7,667.01 STATE OF FLORIDA0050380

Documents

Name Date
WITHDRAWAL 2020-11-05
ANNUAL REPORT 2020-06-12
ANNUAL REPORT 2019-04-30
ANNUAL REPORT 2018-04-24
ANNUAL REPORT 2017-04-27
ANNUAL REPORT 2016-04-02
ANNUAL REPORT 2015-04-17
ANNUAL REPORT 2014-04-27
ANNUAL REPORT 2013-04-23
ANNUAL REPORT 2012-04-23

Date of last update: 02 Mar 2025

Sources: Florida Department of State