| Entity Name: | AMERICAN SENIOR LIVING OF FORT WALTON BEACH, FL, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 09 Feb 2000 (25 years ago) |
| Date of dissolution: | 26 Sep 2008 (16 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2008 (16 years ago) |
| Document Number: | L00000001459 |
| FEI/EIN Number | 650994811 |
| Address: | 3073 HORSESHOE DRIVE, SUTIE 100, NAPLES, FL, 34104, US |
| Mail Address: | 3073 HORSESHOE DRIVE, SUTIE 100, NAPLES, FL, 34104, US |
| ZIP code: | 34104 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043203367 | 2005-08-23 | 2020-08-22 | 1001 MAR WALT DR, FORT WALTON BEACH, FL, 325476780, US | 1001 MAR WALT DR, FORT WALTON BEACH, FL, 325476780, US | |||||||||||||||||||
|
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| Phone | +1 850-863-5174 |
| Fax | 8508634791 |
Authorized person
| Name | MR. THOMAS E RAWLES II |
| Role | VICE PRESIDENT |
| Phone | 2392628006 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF1602096 |
| State | FL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role |
|---|---|
| AMERICAN SENIOR LIVING, INC. | Manager |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2003-04-14 | 3073 HORSESHOE DRIVE, SUTIE 100, NAPLES, FL 34104 | No data |
| CHANGE OF MAILING ADDRESS | 2003-04-14 | 3073 HORSESHOE DRIVE, SUTIE 100, NAPLES, FL 34104 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2007-04-30 |
| ANNUAL REPORT | 2006-04-14 |
| ANNUAL REPORT | 2005-04-14 |
| ANNUAL REPORT | 2004-04-16 |
| ANNUAL REPORT | 2003-04-14 |
| ANNUAL REPORT | 2002-04-22 |
| ANNUAL REPORT | 2001-04-20 |
| Florida Limited Liabilites | 2000-02-09 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
