| Entity Name: | AMERICAN SENIOR LIVING OF SEBRING, FL, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 20 Mar 2000 (25 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: | L00000003415 |
| FEI/EIN Number | 522284226 |
| Address: | 1400 CENTREPARK BLVD, SUITE 810, WEST PALM BEACH, FL, 33401, US |
| Mail Address: | 1400 CENTREPARK BLVD, SUITE 810, WEST PALM BEACH, FL, 33401, US |
| ZIP code: | 33401 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295959815 | 2007-04-13 | 2008-06-12 | 5959 SUN N LAKE BLVD, SEBRING, FL, 338722075, US | 5959 SUN N LAKE BLVD, SEBRING, FL, 338722075, US | |||||||||||||||||||||||||||||
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| Phone | +1 863-385-5454 |
Authorized person
| Name | MEDERIA DORAN |
| Role | EXECUTIVE DIRECTOR |
| Phone | 8633855454 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL5105 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 686324800 |
| State | FL |
| Issuer | MEDICAID |
| Number | 140900000 |
| State | FL |
| LEI number | Registered As | Jurisdiction Of Formation | General Category | Entity Status | Entity created at | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 549300BRBJH4OXZ3ZE46 | L00000003415 | US-FL | GENERAL | ACTIVE | No data | |||||||||||||||||||
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| Legal | C/O C T Corporation System, 1200 South Pine Island Road, Plantation, US-FL, US, 33324 |
| Headquarters | 5692 Strand Court, Naples, US-FL, US, 34110 |
Registration details
| Registration Date | 2014-05-07 |
| Last Update | 2023-08-04 |
| Status | LAPSED |
| Next Renewal | 2015-05-05 |
| LEI Issuer | 5493001KJTIIGC8Y1R12 |
| Corroboration Level | FULLY_CORROBORATED |
| Data Validated As | L00000003415 |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role |
|---|---|
| AMERICAN SENIOR LIVING, INC. | Manager |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000002245 | FAIRWAY PINES AT SUN N LAKE | EXPIRED | 2013-01-07 | 2018-12-31 | No data | 5692 STRAND COURT, 5692 STRAND COURT, NAPLES, FL, 34110 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-04-30 | 1400 CENTREPARK BLVD, SUITE 810, WEST PALM BEACH, FL 33401 | No data |
| CHANGE OF MAILING ADDRESS | 2018-04-30 | 1400 CENTREPARK BLVD, SUITE 810, WEST PALM BEACH, FL 33401 | No data |
| Name | Date |
|---|---|
| Reg. Agent Resignation | 2021-01-12 |
| ANNUAL REPORT | 2019-04-11 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-04-27 |
| ANNUAL REPORT | 2016-04-14 |
| ANNUAL REPORT | 2015-03-30 |
| ANNUAL REPORT | 2014-04-28 |
| ANNUAL REPORT | 2013-04-29 |
| ANNUAL REPORT | 2012-04-24 |
| ANNUAL REPORT | 2011-04-20 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
